By Abigail Funk
Abigail Funk is an Assistant Editor at Training & Conditioning. She can be reached at: afunk@MomentumMedia.com.
Training & Conditioning, 15.7, October 2005, http://www.momentummedia.com/articles/tc/tc1507/theparents.htm
During football preseason a few years ago, Chris Snoddy, MA, LAT, ATC, Head Athletic Trainer at Skyline Medical Center and Goodpasture High School in Madison, Tenn., received a phone call from the father of the team’s starting center. The athlete had been ill and severely dehydrated the day before (he needed two bags of IV fluid) and Snoddy had determined he should not play in the annual football jamboree, a big crowd-drawing, two-quarter length game held the week before the season opener. But the father, who was also a physician, told Snoddy that he wanted his son back on the field for the event. He announced that he had cleared his son to play and expected that it would happen.
As a physician and the athlete’s parent, he did have the right to clear his son for competition. But Snoddy was determined to honor his professional commitment to the health of the athlete. He spoke with the football coach, explaining the importance of resting the athlete so he would be healthy for the season, and the coach agreed. The coach called the father and explained that he wanted to give the second-string center some more experience and that the son would not play. The father didn’t like the decision, but accepted it, realizing that the coach determines playing time.
The athlete started in the season opener the following week, and ended up starting 15 games that year, including the state championship game. He also went on to play at the collegiate level.
There’s a chance that the athlete would have been fine playing in the jamboree, but there was also a good chance he could get sick again if he pushed himself too hard too early. Snoddy was glad he stuck by his medical analysis of the situation. “Dad didn’t really like the decision,” he says. “But it ended up that the jamboree didn’t mean a thing later on.”
Whether they are orthopedic surgeons or stay-at-home moms who never played sports themselves, today’s parents can be pushy. They want what they feel is best for their son or daughter and often won’t let anyone stand in their way, even when it means defying common sense and good judgement. If you work in a high school setting, dealing with parents is part of the job, and it can be frustrating. But, as the above story points out, there are ways to solve parent problems.
Laying The Groundwork
Many problems with parents can be avoided before they start by making sure the entire athletic community understands your role in the department. As Snoddy’s story illustrates, being on the same page as your coaches is critical. When the football player’s father wouldn’t listen to reason, the coach did, and his ability to decide who gets to play made the resolution easier for the father to accept.
Partnering with coaches is also important because parents will often go to the coach with a complaint before they approach the athletic trainer, even if it pertains to sports medicine. “If a parent goes to the coach instead of you as the athletic trainer, you want to make sure the coach will refer the parent to the right place,” says Jennifer O’Donoghue, MA, ATC, CSCS, Athletic Training Program Director at Western Michigan University. “It’s important to develop a hierarchy of communication, and tactfully define the boundaries of your role as a certified athletic trainer.”
From there, ask the coach if you can have 10 minutes to talk at the preseason parents’ meeting. At Charlottesville (Va.) High School, Head Athletic Trainer Ian Rogol, MEd, LAT, ATC, uses that time to talk about what his job entails, his athletic training experience, and his educational background.
“Many of today’s parents did not have athletic trainers when they were in high school,” says Rogol. “They don’t necessarily understand the role of a certified athletic trainer, so I talk about my education and experience, and that seems to put their minds at ease. Now they view me as more of a health care professional instead of a janitor that happens to know how to tape an ankle.”
At these meetings, Rogol says it’s important to come across as a respected member of the athletic department staff. Have the coach introduce you at the meeting, and have him or her help explain your return-to-play procedure. If parents can see that the coach values your expertise and medical opinion, you can more easily gain their trust.
At the same time, Ryan Schroeder, LAT, ATC, Head Athletic Trainer at Muskego (Wis.) High School, suggests making it clear that you are a medical professional, not a coach who can tape ankles. “Communicating that to parents is important,” says Schroeder. “You have to convince them that you’re there because you know what you’re doing.”
Once you’ve established your credibility as a medical professional, you’ll need to gradually build trust with parents. Schroeder not only makes himself available for questions before the season, but continues to make himself visible on the sideline at games and practices.
Many athletic trainers follow the mantra that parents must always be kept in the loop, even when injuries are minor. Rogol recommends that when a student-athlete suffers an injury, you call the athlete’s parents no matter what—even if the injury was just an ankle sprain and the student-athlete simply sat out of practice for 20 minutes to ice it. A follow-up call in the evening is also a good idea as parents will appreciate you taking the time to contact them, which fosters trust and respect.
Schroeder uses an injury sheet that each student-athlete who receives medical attention at school is required to take home to their parent, no matter how trivial the injury is. “It’s so that parents are aware of the situation in case the kid goes home and tells them nothing,” says Schroeder. “There is a list of signs and symptoms for the parent to look for, and they are encouraged to call if they have any questions.”
Snoddy spends a lot of time on his cell phone with parents. “I have every parent’s work, home, cell phone, and pager number, and that list never strays far from me, especially when we’re on the road,” he says. “Parents appreciate that you care enough to call and apprise them of any injury situation with their child. Fostering trust is all about building relationships.”
When an athlete is in rehab, Rogol makes sure that the phone calls home are consistent. “We send home forms and call each day to let them know of any progress," he says. “Some parents are more willing to talk on the phone than others, but usually your attempt to let them know what’s going on is appreciated.”
Sometimes, it doesn’t matter how much effort you make to earn a parent’s trust. Once their child is injured, their mindset immediately changes and you’re back to square one. This is where your professionalism, patience, and people skills must come to the forefront.
O’Donoghue suggests putting yourself in the shoes of the parent to understand what they may be thinking. “From there you can develop a communication strategy that presents and reinforces information from a knowledgeable perspective while also calming the parent,” she says. “You also have to be careful to explain things in a way that parents will understand without being belittling or self-promoting. Talking down to parents only leads to distrust and anger.”
If a parent wants their child to return to play before you think they’re ready, take the time to communicate your return-to-play protocol and your concerns for the athlete. “When Mom or Dad wants their son or daughter back playing, and I know the athlete isn’t ready, I explain to them the demands of the particular sport,” says Rogol. “I’ll tell them, ‘If he or she can’t bear full weight, isn’t able to make a hard cut, and can’t land steadily after jumping, then he or she is not ready.’
“Sometimes you need a physician to back you up and say, ‘These are the eight or nine things they need to be able to do before they’re allowed back on the field,’” continues Rogol. “Then we proceed with rehab updates to parents every day.”
Last year, Schroeder was faced with parents of a student-athlete at Muskego High who were pushing their son to return to play after a rotator cuff injury. “The athlete told me he was ready to go when I knew he wasn’t,” says Schroeder. “I told him, ‘No, you know what the doctor’s orders are, and your parents also need to understand that.’”
Schroeder brought in the athlete’s physical therapist, and between the two of them they were able to make the parents understand the reasons for their decision. “It’s just constant education,” says Schroeder. “The more the parents know about the injury and the rehab, the more comfortable they’ll be with you as an athletic trainer, the rehab process, and your return-to-play decisions.”
Parents can go the other way, too, and not want their child out on the field for fear of re-injury. “Some parents are very hesitant, or what you might call overprotective,” says Rogol. “But if you sit down with them and explain what’s going on, I’ve found that it definitely puts their mind at ease.”
Snoddy once dealt with a case of a very cautious mother who didn’t want her “baby” to risk suffering another injury after rehabbing from a knee injury. Her baby was a 260-pound lineman, one of the biggest and strongest players on the team, but also the youngest child at home.
“I talked to that mother every day about her son,” says Snoddy. “When I told her that myself, the coach, and the doctor thought he was all set and ready to get back on the field, she was still very hesitant. We talked more and eventually I asked her to talk to her son about how he was feeling. That helped, and we continued to go slow, easing him into the rest of the season, respecting her reservations but not giving up on him.”
In the rare instance that a problem parent has become too much for you to handle on your own, don’t be afraid to ask others for help. “If it comes down to it, you can bring in your principal and your athletic director,” says Rogol. “I always try to deal with tough situations myself first and sit down with the difficult parent, but if they’re still off base, I will ask for help.”
The Final Say
A final piece of advice from athletic trainers on dealing with parents is this: Know when to back off. Charles Henderson, LAT, ATC, Head Athletic Trainer at Marcus (Texas) High School, makes sure to remember that parents have the final say in the end, no matter what. “I’m never going to stand in the way of a parent,” he says. “If a parent wants to take their kid to a doctor, even if I don’t feel it’s necessary, I’ll be the first one to agree with them. That’s an instance where you want to give them the best care you can, and if that means Mom and Dad are more comfortable bringing him to a doctor, then you have to be okay with that.”
Part of Charlottesville’s return-to-play policy includes talking to parents before clearing their child to get back on the field. “Most of them will say, ‘We trust your judgement, go right ahead,’” says Rogol. “But even if a doctor gave the athlete clearance and Mom and Dad don’t want their child on the field, then it’s simple—they don’t play. We have to remember that we’re dealing with minors, and their parents have the last word.”
The majority of parents will trust you and your return-to-play decisions. But, when they don’t, remember to see the situation from their perspective. “Parents are demanding because we’re dealing with their pride and joy,” says Rogol. “They just want to be sure that their children are taken care of properly. They want to be 100-percent confident we have their best interests in mind.”
No Talking Allowed
At the high school level, the key to dealing with parents is figuring out an effective communication strategy. At the college level, however, the opposite is often true. You need to figure out an okay way to not communicate with them. Once a student-athlete turns 18, they have the right to not share their medical information with their parents, and that can be a source of major headaches for college athletic trainers.
The Health Insurance Portability and Accountability Act (HIPAA) Privacy Rule is a national law that protects medical records of individuals over the age of 18, and basically gives injured athletes more control over their health information. The Privacy Rule states that a “covered entity,” which includes most colleges and universities, may not disclose an athlete’s health care information without his or her permission, either verbally or through a HIPAA Information Release Form.
“It’s not up to us to talk to a parent,” says Jon Heck, MS, ATC, Coordinator of Athletic Training at Richard Stockton College. “If a kid is leaving on a stretcher, you have to get to him and ask, ‘Hey, can I call your parents and tell them you got hurt?’ It seems strange, but those are the kinds of things you have to do to cover yourself.”
At Western Michigan University, each athlete has the option to sign a HIPAA Information Release Form so their parents can stay apprised of any injury situation. If they don’t sign the form, however, the athletic trainer’s hands are tied when a parent calls wanting information.
“I once had a student-athlete who suffered a head injury and was also in the process of gaining emancipation from his parents,” says Jennifer O’Donoghue, MA, ATC, CSCS, Athletic Training Program Director at Western Michigan University. “His father called and wanted to know all this information, but I said I couldn’t tell him. He threatened to sue the school and did see a lawyer about doing so, but because we were backed up by our protocol, there were no grounds for a lawsuit. It was a very tricky situation.”
Both Heck and O’Donoghue have found that most parents and student-athletes are oblivious to the law—that students just assume you would call their parents and don’t understand why you’d need their permission to do so. At Western Michigan, information is sent to both student-athletes and parents at the beginning of each season, explaining HIPAA and that unless the student-athlete signs the HIPAA Information Release Form, no medical information will be provided to parents. Nevertheless, some parents don’t read or understand the materials sent home.
In these situations, Heck tells the parents he will call them back once the athlete comes in for treatment. “I tell them that way they’ll get the most updated information on how their child is doing,” he says. “And at the same time I can get the athlete’s okay when he or she comes in.”
O’Donoghue often has her athletes call their parents themselves. “It’s really important to put yourself in the parental role sometimes,” says O’Donoghue. “Sometimes it’s better to hear it from your own son or daughter that they suffered an injury. Just don’t give the athlete the worst case scenario of their injury, or that’s all they’ll tell their parents.”
For more information about how HIPAA’s privacy regulations affect college athletic departments, see “Honing in on HIPAA” in the April 2004 issue of Training & Conditioning. It can be accessed online by typing “HIPAA” into the search window at: www.AthleticSearch.com.