Feature Story

August 2019

Survey: Only Half of Collegiate Sports Programs Follow NCAA Model for Student Medical Care

By Chandler Garland

A new survey of college and university athletic trainers shows that 51.73 percent of their collegiate-level sports programs follow the NCAA-legislated independent medical model of care. In addition, 76.26 percent of respondents feel they have medical autonomy—the unchallengeable authority to determine medical management of athletes. The survey was conducted by the National Athletic Trainers’ Association’s (NATA) Intercollegiate Council for Sports Medicine (ICSM). Results suggest a great need for program evaluations.

According to the survey, more than one-third (36.32 percent) reported a coach influenced the hiring or firing of sports medicine staff; 29.95 percent of this group responded to a question subset directly related to receiving pressure from non-medical personnel on medical decisions. Of this subset, which represents 17.37 percent of the total survey response, almost three out of five collegiate athletic trainers (57.81 percent) reported receiving pressure from an administrator, coach or member of the coaching staff to make a decision that was not in the best interest of a student athlete’s health, with about 58.65 percent of this group reporting that they received pressure at least once a month. Furthermore, 18.73 percent of all surveyed reported a coach playing an athlete who had been deemed medically ineligible for participation.

“It is absolutely appropriate and expected for coaches as well as other relevant athletic personnel to ask questions. What is not acceptable is when the inquiry is laced with an expectation to influence, dictate, coerce or challenge the athletic trainer’s autonomous authority to make medical decisions in the sole interest of student athlete health and well-being,” said NATA President Tory Lindley, MA, ATC.

Additional results show that 29.98 percent reported that medical autonomy is affected by sport assignment, meaning some sports may allow more independent medical decision-making than others, and 49.41 percent reported having no formal document that describes the model adopted by the school.

These results suggest that institutions need to evaluate their administrative structure to ensure the institutional line of medical authority is established according to NCAA’s Independent Medical Care for College Student-Athletes inter-association consensus statement and without influence. The NCAA legislation for student athletes is a model that ensures independent medical care by giving primary athletic health care providers—defined as team physicians and athletic trainers—the autonomous authority to make decisions related to the health and safety of athletes without the influences of the athletic department, including coaches and other personnel.

“While we believe that the pendulum is shifting in a positive direction, there is certainly more work to be done. NATA’s goal is to continue to advocate for and support NCAA delivery of care legislation. Student athletes and their parents should feel confident that decisions about health and safety are based solely on medical information and judgment and are not influenced by personnel who are not trained and experienced in that area,” Lindley added.