Canadian Concussion Collaborative Identifies Characteristics of Good Concussion Clinics.
The first sentence of the guide states:
"This guide is designed to help people who have persistent symptoms of a concussion (symptoms that are not clearly improving after a period of seven to 10 days) find a good concussion clinic."
What happened to the first 24 - 72 hours post "possible" concussion? Is this not the most important time period during which to receive professional medical advice? See Your Athlete Was Removed For a Possible Concussion Now What?
The first question states:
Does the clinic have a medical doctor? We lobby for ATCs to be on the sidelines and make critical care decisions in arguably to most difficult situation (on-the-field) for an injury considered to be "among the most complex injuries in sports medicine to diagnose, assess and manage." (Ref) Yet, only MDs are acceptable? Which specialty? And what about DOs, ATCs, neuropsychologists, dare we say LPNs and PAs? See Pediatric providers' attitudes and practices regarding concussion diagnosis and management.
The document goes on to describe the RED FLAGS. Shouldn't these have been given to the patient immediately. It worries us that these Canadian patients are receiving the RED FLAGS 7 - 10 days after initial symptoms. Again, see Your Athlete Was Removed For a Possible Concussion Now What?
How is the patient supposed to know if the providers are up-to-date? Our doctor's note requires the provider to attest to being current. The note was developed by reviewing US state high school sports association notes.
How is the patient supposed to know if the tests recommended by these clinics are proper, especially when there is agreement that most concussions will not be visible on imaging (CISG).
Why are "time-based" fees best? If the doctor is skilled enough to make the diagnosis quickly, isn't that better? We prefer to pay for skill, not time.
Why are website testimonials somehow unethical when we have billboards with testimonials for treatments like bariatric surgery?
If a clinic claims a treatment has been successful for certain concussions (the CISG does not define "types" of concussions), is that better? See Michael Lewis, MD discussing the success of his Omega 3 protocol.
This document is troubling and it is the patient who may ultimately suffer.