TORONTO – More than 30 doctors from around the world congregated in Toronto this past week to discuss ongoing concerns with player safety and treatment. An important topic were head injuries.
“We try every two or three years to bring together our chief medical officers of our members to give them the latest information that we, as the medical committee, have found from the experience of our championships and dealing with concussions from other sports bodies,” medical committee chairman Murray Costello explained.
“It’s mainly to update them and make them more efficient in their countries. When we can, we tie it in to an extra event. This year, that is the American Orthopaedic Society of Sports Medicine, which is having its annual meeting here, and this year it’s hockey specific, so almost all of the doctors from every NHL team were here as well as many other experts and great presentations will take place.”
“Having our chief medical officers here first, and then having them participate in the weekend events is helpful to them and builds the networking possibilities, so they can share information and be a little better in what they do.”
One of the keynote speakers at the event was Dr. Mike Stuart, the chief medical officer for USA Hockey and the father of two NHLers, Mike Jr. and Mark. His topic of discussion was concussions and how to treat the players on ice immediately after one looks to have occurred.
“I presented some real concussion scenarios so that each of our medical supervisors and chief medical officers could put themselves in the position of the health-care provider who’s at the arena when the hockey player sustains an injury,” Dr. Stuart said. “How do we evaluate for a concussion? How do we ensure there’s not an associated neck injury? What is the protocol for removing the player and taking him into the dressing room to give a detailed evaluation? What is the process for follow-up and eventual return to play?”
Not surprisingly, the process from injury to return to play goes from being pretty clear and easy to comprehend to being controversial and murky. That is, any doctor who sees a player incur a severe hit of some sort and then lose consciousness or shows wobbly legs clearly has witnessed a concussion. But as Dr. Stuart notes, that term “return to play” is as slippery as a wall of oil. Several doctors in attendance discussed the difficulty of clearing an athlete to play for a championship game, for instance, when there still might be signs of concussion. The pressure can be enormous.
“We need to educate players, coaches, officials, doctors, and trainers how to diagnose a concussion and everything that goes with this up to the player returning to play,” Dr. Stuart noted. “During competition, the team doctor is responsible for the athletes. But the chief medical officer is there to ensure the highest quality of care. We need to be sure that everyone is following the highest standards.”
Costello agreed. “This year is particularly important because of Olympic qualifying. We have some 42 IIHF events this year, and we need a medical officer at each one to see that the medical side of things is being done properly – not to do it themselves but to oversee operations. This is important because our guys don’t necessarily have jurisdiction to practise medicine in other countries. That’s a big concern of mine. If you are not in your jurisdiction and you give someone medication and things don’t work out, how vulnerable are you? We try to get the local doctors involved.”
Dr. Marc Aubry, another IIHF chief medical officer and one of the staff doctors of the Ottawa Senators, has also been an integral part of the medical committee for years. He, too, acknowledged the importance of assessing head hits.
“Concussions are certainly one of the priorities for us,” he suggested. “I think we recognize the severity of traumatic brain injury, in the short and long term, and the cumulative effects of concussions.”
One of the main reasons to gather as many doctors in one place is the fact that the chief medical officers, while respected, lack direct power over players at events. Thus, the better educated doctors are from every nation, the more consistent will be player treatment from one team or country to another and the greater the quality of that treatment. In the end, the medical committee’s main concern is high and consistent medical attention for every player at every level at all IIHF events.
“Standardizing the process for player treatment is critical,” Dr. Aubry said, “and one of the best ways to do that is through meetings like this. Hopefully the quality of treatment for players will keep getting better as our understanding of their injuries develops.”
NOTE: This was the final committee meeting chaired by Costello, who is retiring as IIHF Vice President after Congress next month (see video story on Costello’s last year as an IIHF Council member). Few men in hockey have had the breadth and longevity of career as Costello. He played four years in the NHL in the glory days of the Original Six. After hanging up his skates, he returned to school, earned a degree and law, and then came back to hockey in that capacity. He was president of the Canadian Amateur Hockey Association for nearly two decades during which time the CAHA merged with Hockey Canada to create a unified federation to oversee all levels of amateur hockey in the country. He also served on the Hockey Hall of Fame’s selection committee and has been an IIHF Council Member since 1998. Costello was inducted to the Hockey Hall of Fame in 2005. He now hangs up his tie nearly half a century after hanging up his skates, but his will forever be a respected and intelligent voice in hockey, the influence of which cannot be overstated.