As summer fun winds down, families make preparations for return to school. For the retail clinician, summertime is back-to-school season. Sports physicals or pre-participation physical evaluation (i.e., PPE) represent an important service in the retail health setting and an important opportunity to impact the child’s health. The required PPE is one of the most common reasons teens seek primary care and may be the only time otherwise healthy teens seek care. While the overarching goal of the PPE is to promote safe sports and physical activities, the PPE provides a real opportunity to evaluate health, promote such vaccines as HPV and meningitis, and provide preventive counseling.
The PPE should be ideally administered when the child is not ill and six to eight weeks prior to beginning the sport or practice season to allow for further evaluation or rehabilitation of any problems that could be discovered at the time of the exam. While the medical history is best taken from an adult parent or caregiver with long-standing knowledge of the child, adolescents should be seen apart from the parent for part of the exam to allow the clinician to inquire about risk-taking behaviors. Retail clinicians should set the stage for this early in the evaluation. In addition to a complete medical history, a standard head-to-toe exam with a brief musculoskeletal assessment is required. The most common conditions warranting further evaluation or referral to a personal care provider or a specialist will be identified during the cardiac and musculoskeletal exam.
Remembering that since the sports physical might be the only time this child or teen interacts with a healthcare provider during the year, the PPE is an excellent opportunity to provide preventive counseling and health guidance for both the patient and parent. With the understanding that time constraints limit the amount and content of counseling, pertinent topics should be individualized and based on the history obtained during the course of the PPE. Topics might include: safety (e.g., seatbelt use and safe driving, helmets and protective equipment); importance of proper rest and hydration, sun protection, steroid avoidance (i.e., tobacco, alcohol and drug use should be addressed at any teen health visit); breast/testicular self-exam; and abstinence or condom use encouraged to prevent pregnancy, HIV transmission and other sexually transmitted infections.
Retail clinicians may refer to the chapter on Sports Physicals in a new industry textbook “Convenient Care Clinics: The Essential Guide to Retail Clinics for Clinicians, Managers, and Educators.”