Over the past few months, the sports world has seen the process that the University of Maryland has endured in the wake of the death of football player Jordan McNair from heat stroke. As Athletic Trainers (ATs), we’ve written emergency action plans, updated them, practiced them and implemented them. Sometimes having all the right policies and procedures in place isn’t enough. When it’s not the policies or procedures that fail us, where do we look for answers?

We cannot change the facts of that day. Pointing fingers does not alter the outcome. What we can do is find the take home messages, start discussions and create a culture focused on change. We can look for guidance from our association for ways to bring about positive change.

In August, the National Athletic Trainer’s Association (NATA) issued a statement regarding the model of delivering sports medicine services in the collegiate setting, and there are a few models identified. Within the institution, there are multiple locations where ATs have been housed: athletics, academics or university health. Additionally, the team physician may be employed by the institution or by an outside entity, independent of the status of the AT staff.1 Traditionally, the AT staff has been housed in the athletics department. However, these models have been examined with more frequency over the past few years.

The NATA’s position on this topic is the medical model is the “gold standard.” ATs can make decisions related to the health and safety of their patients without fear of repercussions from the athletic department.2 Not only does this create a structure where the AT has the ability to make independent medical decisions based on their clinical expertise, but many institutions that have already transitioned to this model report improved work-life balance and pay structure compared to their traditional model counterparts.3 The most common perceived disadvantage of this model reported was the increased challenge of communication between ATs and coaches or athletics staff. However, research has shown that these challenges remain the same between employment models.4 Research indicates that the medical model is what’s best for all parties.

The University of North Carolina reported that in 1971, they had a similar case where their football program lost a player due to heat illness. Their response was to overhaul how they treated sports medicine in their institution, house the AT staff in student health services and put resources into the health and safety of their student athletes.3 Their reaction to tragedy was to ensure this would never occur again. This happened over 45 years ago. In 2017, the University of Maryland had discussions regarding changing to the medical model of delivery of athletic training services but talks stalled, as some parties involved did not think a change was necessary.5

In any employment setting, it’s important to be proactive, not reactive. In discussing what is best for our student athletes and patients, let’s create an environment focused on patient centered care. Let’s start a discussion on what that means for the collegiate athletic training model. Let’s start that discussion now.

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