Sports physicals: It’s best to root for the “home” team
It may be more convenient for teens to get sports physicals at a grocery store clinic instead of their primary care doctor’s office. But they may not realize what they’re giving up in exchange for such easy access.
Sports physicals are considered preventive well-care visits, according to Camille Graham, MD, executive community physician leader at Cincinnati Children’s. “Preventive care is now covered without deductibles or co-payments by most insurance plans, so there usually is no charge if you go to your pediatrician,” she explains. “Sports physicals that are done outside the medical home in a gym or a retail-based health center charge a fee.”
But even more importantly, when sports physicals take place in the medical home, patients receive care from someone who knows their medical history.
At the preventive visit, pediatricians monitor growth and development; conduct a comprehensive physical examination; address previous and current medical problems; update immunizations; perform recommended screenings and give appropriate anticipatory guidance. They also are tuned in to behavioral and mental health problems; learning difficulties; tobacco, alcohol and substance use; social problems and sexual activity.
“When a teen goes to a gym or retail-based health center for their sports physical, the exam is cursory and performed without the child’s complete medical history,” says Graham. “In these settings, preventive care issues are rarely addressed. There is little to no communication back to the medical home, and there is no anticipation of a future relationship. Unfortunately, when children get this kind of exam, many parents don’t see a need for a visit to their primary care provider for a second ‘physical.’”
Another unintended consequence of sports physicals performed outside the medical home is the subtle message to teens that they should seek care only for self-limited problems, e.g., a form for sports, instead of proactively getting annual visits for regular preventive care. Says Graham, “With the increase in mental health issues, substance abuse, eating disorders and obesity in our community, teens need care in settings that will identify and treat these problems.”
Pediatricians can help stem the flow of visits to retail-based health centers by improving accessibility in their own practices and promoting the medical home advantage.
Last year, the Cincinnati Pediatric Society sent letters to area high school principals and coaches emphasizing the benefit of the sports physical occurring in the medical home. The letter included this statement:
“Pediatricians encourage physical activity for all children, especially given the rising epidemic of childhood obesity. We believe that youth involvement in sports fosters physical fitness, improves self-esteem and promotes teamwork. We also believe that children deserve quality healthcare. Those entrusted with responsibility for our children, like pediatricians, teachers and coaches, should never promote convenience over quality. The children in our community deserve the best and not what is most expedient.”
(Note: Cincinnati Children's Sports Medicine offers sports physicals at certain Cincinnati public schools to students who do not have a primary care physician.)
