Sports Medicine: Rooting a Wellness Paradigm Firmly Into Clinical Practice

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Sports Medicine Rooting a Wellness Paradigm
Firmly Into Clinical Practice
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Wellness is a multidimensional state of being
describing the existence of positive health in an
individual as exemplified by quality of life and
a sense of well-being.

• Presidents Council on Physical Fitness and
  Sports Research Digest. Dec 20013(15).

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Wellness and Disease Risk

• Regular exercise and enhanced fitness
• Reduces all-cause premature death
• Reduces cardiovascular mortality
• Reduces risk of developing
• Diabetes
• High blood pressure
• Colon cancer
• Breast cancer

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Wellness and Disease Management

• Regular exercise and enhanced fitness
• Reduces pre-established high blood pressure
• Prolongs survival following a heart attack
• Improves impaired blood sugar control
• Improves abnormal blood lipid ratios
• Reduces the incidence of obesity
• Reduces subjective depression and anxiety
• Decreases elderly fall risk and prolongs
  independence

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Economic Impact of Wellness

• Investment in workplace wellness initiatives are
  proven to produce a positive return-on-investment
• Multiple exercise initiatives targeting patients
  with chronic disease have shown benefits in
  cost-effectiveness from decreased rates of
  hospitalization and decreased rates of secondary
  complications

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Exercise Prescription is Cost-Effective
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Medicine and Wellness

• Clinical medicine is by necessity largely a
  disease-focused entity
• The focus on healthcare expenditures is centered
  around management of established disease rather
  than on prevention
• The practice of most medical specialties reflect
  this focus

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What is Sports Medicine?

• Sports Medicine has been a recognized
  subspecialty by the American Board of Medical
  Specialists since 1992
• Sports Medicine is the only specialty whose
  origins are firmly grounded in wellness and
  preventative medicine
• The practice of Sports Medicine revolves around
  preservation of form and function

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What is Sports Medicine?

• There are currently over 110 accredited Sports
  Medicine Fellowships in the United States
• There are currently over 1750 board-certified
  Sports Medicine physicians in the United States
• Sports Medicine is poised for growth as a
  specialty dedicated to wellness-promotion
• Sports Medicine promotes cost-effective care

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What is a Sports Medicine Physician?

• Sports Medicine physicians
• Maintain board certification in a primary
  specialty
• Family Medicine
• Internal Medicine
• Pediatrics
• Emergency Medicine
• Physical Medicine and Rehabilitation
• Maintain additional board certification in Sports
  Medicine

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What is a Sports Medicine Physician?

• Sports Medicine physicians
• Have graduated from an accredited (through the
  Accreditation Council for Graduate Medical
  Education) post-residency fellowship program
• Maintain their skills through annual continuing
  medical education
• Because of their background in wellness and
  primary care, are uniquely qualified for
  leadership within the Medical Home Model of care
  currently being promoted as an optimal care
  delivery mode

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What is Sports Medicine?

• Sports Medicine physicians receive training in
• Exercise prescription
• Tools to promote lifelong fitness and wellness
  through disease and injury prevention
• Tools to manage established disease
  cost-effectively through exercise
• Ways to help patients maximize function, and
  minimize disability, and thus time away from
  work, school or sports

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What is Sports Medicine?

• Sports Medicine emphasizes the application of the
  principles of medicine, applied physiology and
  unique characteristics of medical conditions as
  they pertain to lifestyle, physical activity and
  athletics
• This encompasses a broad spectrum of lifestyle,
  activity and sports-oriented training, both
  musculoskeletal and non-musculoskeletal

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Sports Medicine and Orthopaedics

• Sports Medicine physicians are trained to
  recognize when rapid referral for surgical repair
  is optimal both for patient outcome and
  cost-effectiveness of care. Diagnostic accuracy
  is greater than for other non-orthopaedic
  specialties
• Sports Medicine physicians routinely employ use
  of patient-specific home exercise programs which
  minimize the need for more expensive supervised
  physical therapy programs

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Sports Medicine is unique

• Sports Medicine physicians are specifically
  trained in, and specialize in the non-operative
  management of injury
• Average cost of rotator cuff repair 20-25,000
• Average cost of (pre-operative) physical therapy
  for rotator cuff disease 1500-3000
• Average cost of Sports Medicine physician
  consultation and provision of directed home
  exercise program 150

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Sports Medicine is unique

• 90 of all injuries are ultimately non-operative
  in nature, but many injuries that are not
  repaired surgically still carry significant
  morbidity and loss of function
• Sports Medicine physicians are trained to
  evaluate injured patients with the goal of
  returning them to pre-injury function
  nonoperatively. This requires thorough
  evaluation of the patient to get to the
  biomechanical root of the problem

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Sports Medicine is unique

• Sports Medicine physicians receive additional
  training in non-musculoskeletal topics germane to
  the field
• Exercise Prescription
• Healthy, but sedentary patients
• Patients with chronic disease
• Clinical exercise testing
• Pre-activity screening for disease or injury
  risk
• Post-injury risk assessment
• Concussion management
• Optimal care of the industrial athlete

• Nutritional consultation
• Sports psychology
• Bone mineral density problems
• Healthy lifestyle promotion
• Event coverage
• Coordinators of global medical and rehabilitative
  care in a team approach
• Surgeons
• Athletic Trainers
• Physical Therapists
• Coaches
• Athletes

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Insurance Benefits

• Exercise prescription and counseling has a higher
  likelihood of resulting in effective behavior
  change coming from the Sports Medicine
  physicians office than from Primary Care
• Sports Medicine physicians are ideal health care
  providers for sedentary patients looking to
  become active in a safe, structured way
• Sports Medicine practitioners are cost-effective
  utilizers of medial imaging services

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Insurance Benefits

• Sports Medicine physicians are equipped to teach
  patient self-management tools
• Most patients otherwise receive inadequate
  exercise counseling
• One quarter to one third of the population is
  completely sedentary
• Slight increases in activity have been proven to
  effect large changes in cardiovascular mortality
• Proper motivation change medical savings

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Sports Medicine Credentialling

• Why is credentialling as Sports Medicine
  important?
• A valid Sports Medicine option remains an
  effective way to attract top medical student
  applicants into primary care residencies.
• Ongoing challenges with credentialling may lead
  to a decrease in the number of Sports Medicine
  physicians entering an already dwindling primary
  care field

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Sports Medicine Credentialling

• Why is the Sports Medicine designation
  important?
• Parity The majority of third party payors
  already duly recognize Sports Medicine as an
  independent subspecialty

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The American Medical Society for Sports Medicine

• The AMSSM
• Is the nations largest group of Sports Medicine
  physicians
• Was founded in 1991 by a group of primary care
  physicians who recognized the need for an
  organization that approached patient care with
  respect to exercise and injury comprehensively
• Musculoskeletal
• Medical
• Nutritional
• Psychosocial

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The A.M.S.S.M.

• The AMSSM is a catalyst for the production of
  clinical research in Sports Medicine
• Mission Statement
• To offer a forum that fosters a collegial
  relationship among dedicated, competent Sports
  Medicine physicians as they seek to improve their
  individual expertise and raise, with integrity,
  the general level of sports medicine practice.

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The A.M.S.S.M.

• The AMSSM applies Sports Medicine concepts to
  athletes of all levels
• Grade school/middle school
• High school
• College
• Professional
• Recreational

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The A.M.S.S.M.

• Organizational goals
• To develop and maintain a national society of
  Sports Medicine physicians who share a common
  philosophy, knowledge and expertise related to
  Sports Medicine and its practice
• To encourage and support research in Sports
  Medicine
• To encourage and support development and regular
  review of the Sports Medicine knowledge base
• To provide a link between the rapidly expanding
  core knowledge related to Sports Medicine and
  its application in a clinical setting

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The A.M.S.S.M.

• Organizational Goals
• To develop position statements, guidelines and
  educational materials for professional, public
  and industry use
• To provide a venue for ideas and
  information-sharing among colleagues
• To promote the health and safety of athletes and
  physically active individuals through education
  of all individuals involved in their care

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Resources

• www.amssm.org
• AMSSM National Office
• 11639 Earnshaw Overland Park, KS 66210
• Phone (913) 327 - 1415
• Fax (913) 327 - 1491
• Email office_at_amssm.org