Colleges and universities are being challenged to provide the best possible comprehensive medical care (medical services, physical therapy, athletic training) available for student-athletes.

This challenge, and its impact on the resources available to the intercollegiate athletics department and the student-athlete, has increased in recent years. This increase is due to many factors: meeting the compliance requirements associated with Title IX; consistently expanding "out-of-season" skill and conditioning sessions that increased exposure of the student-athlete to potential injuries; and legal precedents establishing an institution's heightened duty and responsibility toward the standard of care afforded to all student-athletes, regardless of sport or gender.

The challenge is driven by societal expectations for access to, and deliverance of, both high-quality and comprehensive medical care services. These expectations may be even greater for families of intercollegiate student-athletes who are injured while representing an academic institution. Comprehensive medical care requires that academic institutions and intercollegiate athletics departments strive to provide access to the highest standard of care available in the local community. Records and documentation demonstrating the type, level and quality of care received, and the outcome of that care, should be readily available.

Members of the medical care team should be considered based upon their expertise in a certain area, the frequency upon which their expertise is required, and their ability to have a positive impact on the prevention, diagnosis or management of injuries and illnesses suffered by student-athletes. Historically, and traditionally, many medical care teams have been composed of team physicians and athletic trainers. Physical therapists, experienced in orthopedics and sports, have expertise in the examination/evaluation, diagnosis and management of athletics injuries and should be considered for more consistent inclusion in the medical care team. As a member of the medical care team, physical therapists can contribute their knowledge, skill and expertise in the prevention, evaluation and rehabilitative management of the neuromuscular and musculoskeletal injuries and have a positive impact on the care provided for athletics injuries. The unique knowledge, skill and expertise of the physical therapist would provide a greater depth and scope of services available to the medical care team, complementing the contributions provided by the team physicians and athletic trainers.

As part of the academic institution's medical care team, the physical therapist can help facilitate the highest standard of rehabilitation management possible, improve access to required services, and improve documentation and compliance with federal or state rules and regulations that govern professional standards of care. Maintaining the presence of a professional dedicated to the rehabilitative management of the injured student-athlete may allow other members of the medical care team to provide improved practice/venue coverage, increased availability for team travel, and increased time for interaction with student- athletes, coaches and families.

The addition of a physical therapist also may result in reduced administrative concerns regarding burnout of athletic training staff, overtime, compensatory time or contract issues. Members of the medical care team could function optimally by providing the types of management that are within the scope of their education and practice. They also would have increased opportunities for communication with other members of the medical care team, coaches and student-athletes.

In an era of budgetary restrictions and requests for cost containment, the demand for increased medical care services for student-athletes is pressing on many academic institutions and athletics departments. Obviously, the direct employment of a specific type of provider is one possibility. However, based upon the resources available to the institution, strategic partnerships and creative solutions that draw upon the strengths and availability of services from the various health care providers and institutions in the area also should be considered. Many different types of partnerships and solutions could be developed between the academic institution's current team and local hospitals, physician groups, physical therapists (hospital-based or private practice) and other health care professionals that allow each professional to provide the highest level of expertise and service possible to the student-athlete.