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Ethical, Legal, and Administrative Considerations for Preparticipation Evaluation for Wilderness Sports and Adventures

Young, Craig C. MD*,†; Campbell, Aaron D. MD, MHS; Lemery, Jay MD§; Young, David S. MD

Clinical Journal of Sport Medicine: September 2015 - Volume 25 - Issue 5 - p 388–391
doi: 10.1097/JSM.0000000000000246
Care of the Wilderness Athlete

Abstract: Preparticipation evaluations (PPEs) are common in team, organized, or traditional sports but not common in wilderness sports or adventures. Regarding ethical, legal, and administrative considerations, the same principles can be used as in traditional sports. Clinicians should be trained to perform such a PPE to avoid missing essential components and to maximize the quality of the PPE. In general, participants' privacy should be observed; office-based settings may be best for professional and billing purposes, and adequate documentation of a complete evaluation, including clearance issues, should be essential components. Additional environmental and personal health issues relative to the wilderness activity should be documented, and referral for further screening should be made as deemed necessary, if unable to be performed by the primary clinician. Travel medicine principles should be incorporated, and recommendations for travel or adventure insurance should be made.

*Departments of Orthopaedic Surgery; and

Community and Family Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin;

Family and Sports Medicine, University of Utah, Salt Lake City, Utah;

§Department of Emergency Medicine, University of Colorado School of Medicine, Aurora, Colorado; and

Department of Emergency Medicine, University of Colorado, Denver, Colorado.

Corresponding Author: Craig C. Young, MD, 9200 W Wisconsin Ave Box 26099, Milwaukee, WI 53226-0099 (

Jay Lemery MD is a former president of the Wilderness Medical Society, is a consultant to the Centers for Disease Control and Prevention (CDC) and has received royalties from Rowman & Littlefield. The remaining authors report no conflicts of interest.

This article appears in a “Care of the Wilderness and Adventure Athlete” special issue, jointly published by Clinical Journal of Sport Medicine and Wilderness & Environmental Medicine.

Received March 28, 2015

Accepted June 19, 2015

Copyright © 2015 Wolters Kluwer Health, Inc. All rights reserved.