A School Physician’s Story

A School Physician’s Story

by Dr. Daniel Rancier MD

A School Physician has many responsibilities, but they all aim at promoting the safety and health of the children. One responsibility is being on the sideline for High School Football games. When there is an injury, especially a concussion, there are times when even the student athlete’s parents do not seem to share the same concern for safety. It is these times when it is my job to protect the students from harm even when their parents do not seem to understand. It takes a diplomatic approach and sound evidence to help parents understand how to manage a concussion properly.

Did you know that my son is probably the best player on his team?” Dad barked at me!

I don’t care if he is the quarterback of our team. He has had a concussion and isn’t going back into the game.” I calmly replied.

Several years ago I was at a home football game for the school that I am the physician. Part way through the first quarter the other team was on offense and as their running back turned the corner to make a run up the field. As he rounded the corner along the sideline where I was standing the cornerback for our team came out of nowhere and tackled him to the ground. The most sickening “THWACK” was heard when they collided and when the dust cleared the opposing team’s running back was lying face down on the field and not moving.

We immediately ran over to him and found him to be conscious but confused with a headache. They took him to the sideline where I evaluated him with an old method we used back then for assessing concussions. No SCAT 3 or any version of it was available at the time. I held onto his helmet and informed his coach that he would not return to the game.

Even back then his coach did not question my decision, but Dad did.

I proceeded to go to the stands where Dad was and had to explain to him why his “star” son could not go back into the game that night. After much convincing and persuading, he finally relented as he, of course, did have his son’s best interest at heart.

If only I had a tool like the SCAT 3 to aid me in my medical decision-making and to show Dad why his son could not go back into the game, it would have made it so much quicker and easier.

The next day our local newspaper featured that game on the front page of the sports section. It described in detail the play where the running back sustained his concussion. It went as far as to describe the hit and the awful sound that resonated throughout the stadium. Had I let him back into the game it not only would have put the player at risk but it would have appeared incompetent to the whole community.

The SCAT 3 is the most universal and respected method for assessing sideline concussions. All Coaches, Athletic Trainers, school nurses, Nurse Practitioners, Physician’s Assistants, MD/DO’s should use the SCAT3 international standard as should anyone who assess the athlete on the sideline. Since its introduction, it is the only tool we use at my school, and it has made assessing concussions and managing return-to-play standardized, efficient, and clear to the athlete and parents. Given it is the most widely standard for assessing concussions, it should support the decisions made on the sideline in a court of law should it come to that.

The young football player did not return to that game, and he uneventfully recovered without any long-term consequences. Once again the health and safety of our students and athletes were upheld.

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