Why Urgent Care Isn’t Always The Best Place For A Sports Physical

Before I share a few reasons why urgent care isn’t always the best place for a sports physical, I want you to know that I understand. I understand that urgent care is convenient. I understand that you probably have a little-to-no wait time when you go there. I understand that you don’t have to make an appointment. And most of all, I understand that your teenager likely told you approximately 5 minutes ago that their sports physical is due tomorrow morning at 8am (sorry, can’t help you there!). I don’t question for a minute why you would want to go to urgent care to simply get that sports physical checked off of your long to-do list. Hundreds of thousands of sports physicals take place in urgent care facilities across the nation every year.

The sports physical is an annual pain-in-the butt to many parents, and this is the time of year when those pesky sports physical forms are due. When parents come to me with sports physical forms in-tow, you can usually see that look of “why must we do this year after year” written all over everyone’s faces.

I’ve done sports physicals at a primary care pediatric office for well over 5 years, and switched to pediatric urgent care a year ago. Now, after doing sports physicals in both facilities, from my perspective as a pediatric provider, I can tell you that there are some specific benefits that make your primary care pediatric office the office of choice when it comes to sports physicals.

Why Urgent Care Isn’t Always The Best Place For A Sports Physical

Here are 5 reasons why your primary pediatric care office is likely the better option for your child’s sports physical than urgent care.

1. Most urgent care facilities don’t specialize in children.

Children are not little adults. They are different, and the way we provide healthcare needs to be specific to their developmental needs.

Most urgent care facilities provide care to anyone at any age. They are run by general family physicians and nurse practitioners who were taught “cradle to grave” medicine, meaning, the entire lifespan. Pediatricians and pediatric nurse practitioners spend many years studying to specialize in the care of children. Instead of focusing on all ages, we focus on birth to 18 years old. While I have no problem with family physicians and family nurse practitioners, pediatric providers are more specialized for children.

2. Knowing your child’s medical history is very important when completing their sports physical. Their primary care pediatric provider generally knows that history best.

In medical terms, we call your child’s primary care office their medical home. It is essentially the home base of their medical care. Well visits, sick visits, and coordination of referrals or records from acute hospitalizations should be kept at your pediatric medical home. The main purpose of a sports physical is to determine your child’s medical safety to participate in sports. In order to thoroughly do so, it is important to have access to their medical records, especially their cardiac history.

Let me demonstrate this concept with an example. A few weeks ago, I was doing a sports physical for a young athlete at the pediatric urgent care where I work. I learned from her mom that the child’s uncle died unexpectedly from a form of heart disease while still in his 30’s. In terms of signing off on sports physicals, his death is a major red flag. Mom said that her child was cleared for physical activity by a cardiologist at some point several years ago, and she had a clear EKG performed by her primary pediatric provider last year.

As the urgent care provider, this puts me in a difficult situation. What did the notes from her cardiologist say? How specifically did her uncle die? What were the exact results of the EKG and how often should that be repeated? This is information her primary care provider had, but in an urgent care setting, we don’t have access to. While this mom was understandably hoping to save time by taking her child to urgent care, it actually cost her more time and money. Ultimately, she had to go back to her primary pediatric office since they were the only ones with the vital access to the needed information in her child’s medical history.

Now, you might be thinking, what if my child doesn’t have any significant medical history? What now? This is a list of 9 questions that any medical provider (whether in primary care or urgent care) should be asking during your sports physical visit.

9 Questions Your Medical Provider Should Ask During A Sports Physical: 

1. Have you ever passed out or nearly passed out during exercise?
2. Have you ever passed out or nearly passed out after exercise?
3. Have you ever had discomfort, pain, or pressure in your chest during exercise?
4. Does your heart race or skip beats during exercise?
5. Has a doctor ever told you that you have a heart murmur?
6. Has a doctor ever ordered a test for your heart (for example, EKG, echocardiogram)?
7. Has anyone in your family died for no apparent reason?
8. Does anyone in your family have a heart problem?
9. Has any family member or relative died of heart problems or of sudden death before age 50?

If the answer to any of these questions is yes, it is even more important to discuss these topics with your primary pediatric care provider to ensure proper follow up. Your primary pediatric care provider is better equipped to do so than most urgent care facilities.

3. Having an appointment time is helpful for everyone.

I know the allure of walk-in appointments. Generally, they are quite convenient for the patient. While I completely understand that, sometimes walk-in appointments can also lead to scheduling chaos. At urgent care, it can be quiet for hours, then as soon as school gets out, or dinner is over, I have about 10 kids waiting to see me all at the same time. The other day, my exam rooms were full (for hours!) with seriously ill children needing immediate attention (x-rays, suturing, splitting, etc) and kids needing sports physicals scattered in between. Obviously, a similar situation can happen at primary care offices, but scheduling an appointment in advance generally does help control the pace. At urgent care, it really is luck of the draw. You might be the only one there, or you might be the 14th in line. It doesn’t always save as much time as you may think.

4. Going to an office with immunizations is crucial.

Another important element of sports physicals is making sure your child is up to date on immunizations. Unless you bring your immunization record with you to urgent care (and most parents don’t), the urgent care facility won’t know what immunizations your child needs (remember point #2 – they don’t have your child’s medical records). Furthermore, even if they do know the immunizations your child needs, most urgent care facilities don’t routinely carry childhood vaccines.

The other day, I saw an 11 year old for a sports physical at urgent care. While she completed her sports physical, she would still need to make an appointment with her primary care pediatric provider to get her TDaP, Meningococcal, and HPV vaccines because our urgent care didn’t carry them.

KidNurse Tip: If you aren’t sure what immunizations your child needs, I’d encourage you to look at this immunization schedule for 7-18 year olds from the CDC.

Also, if you still plan on taking your child to an urgent care for a sports physical, and you know he or she needs vaccines, I’d definitely call the urgent care ahead to see if they stock the vaccines your child needs. Most of the time, that answer is no. Urgent cares specialize in the treatment of common illnesses and injuries, not in preventative care.

5. In-depth conversations about wellness topics and preventative care with young adults matter (alcohol, sex, drugs, etc – you know, all the things we don’t really want to think about).

Here’s a few current sobering statistics that are important for parents of teenagers in particular to remember:

• People aged 12 to 20 years drink 11% of all alcohol consumed in the United States.
• A survey of more than 46,000 teens showed that 13 percent of 8th graders, 30 percent of 10th graders, and 40 percent of 12th graders say they have used a drug at least once in the past year.
• 30% of all high school students reported being sexually active, and that statistic jumps up to 46% of students by the 12th grade.

It’s important for healthcare providers to talk to young adults about these topics and the health consequences they have. And that doesn’t even touch on other important topics including school success, nutrition, sleep, growth, etc. Sports physicals are one of the most common reasons a teenager has to get medical care, and they present us with a unique opportunity to address these important wellness issues. It is far more likely for these topics to be addressed within a child’s medical home, where they have an established relationship with their primary care pediatric provider. The logistics of a fast-past urgent care isn’t primed for an in-depth discussion on frequently sensitive topics.

5.2. Even kids who aren’t playing sports need to check-in with their pediatric care providers.

Whether your child is an athlete or not, the American Academy of Pediatrics recommends a well visit for children every year. So remember to take your tween or teen in for a visit to cover these important wellness topics and stay up to date on their vaccinations (even if they don’t need a sports physical).

Once your healthcare provider has signed off on your kid’s sports physical form, and they make the team, remember those 9 questions covered during a sports physical. If your child begins experiencing any of the first few symptoms during practices or games (passing out, pressure in the chest, heart skipping a beat), take them back to their healthcare provider for a follow-up appointment immediately. Now, play ball!

Author: Dani Stringer, MSN, CPNP, PMHS – founder of KidNurse and MomNurse Academy