Evidence of meeting #5 for Subcommittee on Sports-Related Concussions in Canada in the 42nd Parliament, 1st Session. (The original version is on Parliament’s site, as are the minutes.) The winning word was going.
A video is available from Parliament.
7:40 p.m.
Barrie—Springwater—Oro-Medonte, CPC
Thank you.
Chris, I know that this is a bit of a hot button question, because any time we discuss health care with Americans we're liable to end up needing the police or something. I'm going to go there anyway.
7:40 p.m.
Barrie—Springwater—Oro-Medonte, CPC
I think you heard me earlier. In health care in Ontario, they have a computer system in which they have to create—
7:40 p.m.
Barrie—Springwater—Oro-Medonte, CPC
How do you bill? When you're looking at somebody who looks like they have the effects of a concussion and have a need for a personal trainer, or for some sort of massage therapy in some cases, or potentially a need for someone who can look at the nerve damage in other parts of the body, a huge number of people are needed.
7:45 p.m.
Barrie—Springwater—Oro-Medonte, CPC
How do you guys tackle that in the U.S. with your system when you see a young person, let's say? Is it that you're S.O.L. if you don't have insurance? What happens?
7:45 p.m.
Chief Executive Officer, Concussion Legacy Foundation
Yes, if you don't have insurance, you're in big trouble. That's a huge issue in the United States, and I don't know how to solve that problem here.
Let's go back to the original question about billing codes and rehabilitation. I think you have identified a major issue here. If you don't have appropriate reimbursement and billing codes for doctors so that they can give proper care for concussions, that's something you could fix. That's easy. We know that most people aren't going to need extensive therapy, but some are.
7:45 p.m.
Barrie—Springwater—Oro-Medonte, CPC
It further discourages doctors from taking it on.
7:45 p.m.
Chief Executive Officer, Concussion Legacy Foundation
Yes, that's right, and building his practice....
7:45 p.m.
Barrie—Springwater—Oro-Medonte, CPC
Right. If we believe that it's about entertainment and about money in that world—Rosemarie and I have been talking about this on the side here—there is an aspect to that within the health world as well.
7:45 p.m.
Chief Executive Officer, Concussion Legacy Foundation
Right. Just to give you an example, in the U.S. we used to call our concussion education sessions “concussion clinics”, because there were no physical clinics that treated concussions. There are now well over a thousand. Every major hospital has a concussion clinic where you send kids. They have multidisciplinary teams to help assess what's wrong and how to fix you. Do you need vestibular rehab, visual rehab, cognitive behavioural therapy or whatever it is? They're doing it, so hopefully kids are going to have better outcomes down the road.
7:45 p.m.
Chief Executive Officer, Concussion Legacy Foundation
Yes. That's something you need.
7:45 p.m.
Mr. Peter Fonseca (Mississauga East—Cooksville, Lib.)
We're going to move over to the NDP. This will be our last questioner.
Chris, you may want to put on the table whatever you want all of us to hear.
7:45 p.m.
Chief Executive Officer, Concussion Legacy Foundation
No, I feel like I've said a lot on most of the things.
7:45 p.m.
Windsor—Tecumseh, NDP
Okay.
I would like you to go back to telling us a bit about what is common and not disputed anymore.
Rosemarie was talking about her daughter and how much her daughter loves sports. That has been the problem perpetually. Kids love it, and then parents feel good when they see their kids doing it. The kids get positive reinforcement, so they do it. First thing you know, you're a fan paying the money for a professional sport; it's not just about the amateur. It just cycles and cycles and cycles.
I would love to bring it back to what we know now that we didn't know in the 1990s. What is not disputable?
You were on a roll a bit, and I would love to hear more about that. Even if you just want to talk about the developing brain and contact sports, for instance, when did we find that out?
7:45 p.m.
Chief Executive Officer, Concussion Legacy Foundation
That's a good point. All right, where do I take this?
The interesting thing is that a lot of stuff we're talking about today has been in the medical literature forever. We've always known that a hit to the head can cause your brain to malfunction. It can cause structural injury. It can cause symptoms, most of which are acute, but some can become very long-term. We now know that those hits to the head can lead to degeneration and problems down the road.
We know that those hits to the head are probably worse when you're young. Kids take not only longer to recover, but there are things called developmental windows in the brain. If children have a brain injury before they're supposed to develop a certain skill—a good example would be if a kid has a brain injury before he learns to speak—they're going to be delayed dramatically and they may never catch up.
The idea that we need to protect kids is well accepted. What's interesting is that what is not accepted is the idea that we shouldn't hit kids on the head. I think that's the best way to look at this. That is not an accepted premise in North America. I like to steer the conversation there all the time.
The best thing we can do for all of these issues is prevent them. We can get into medical billing and all the nuances of what to do for you once you are in the system, but the biggest opportunity we have is prevention. We need to use our influence and knowledge to rein in sport, which in a lot of ways has become more about boosting enrolment and capitalism, creating jobs, than about necessarily doing what's best for your kid.
The idea we have today on year-round sports still boggles my mind. In my dissertation, I had to deal with an issue where I was studying a soccer team in a high school. I put sensors on their heads, and we were counting how many times they were hit on the head. I didn't imagine that the kids were also allowed to play on a private soccer team the other days of the week. I didn't realize it until afterwards, and I had to put that in my limitations, that these kids were also playing soccer somewhere else, 7 days a week, some of them for 12 months a year.
When we look at how bad the brains at our brain bank are today, those were athletes who were playing probably three or four months a year—a season a year of sports. We don't have a lot of 12-month-a-year soccer players. We also don't have “bigger, stronger, faster” in there. That's something we don't talk about either: our increased training and nutrition. If you look at an NFL team, they're 20% larger. They are faster than they were, and their brains are no tougher. The idea that.... You will hear that we've solved most of this problem and it's behind us, but that's not the most likely situation.
The worst of this is coming, which is why we're so dedicated to saying, “Let's draw a line in the sand. Let's fix what we can now. Let's stop creating this by letting kids get hit on the head, for years, while their brains are developing. Then, let's really dig in and try to help the folks who have been damaged.”
It's not just athletes; it's also our veterans. Whether it's our veterans or your veterans, they are people who have served our countries and need help. Unless we really invest and create this research roadmap and put money towards it, we won't have answers.
I'm now 40 years old, and I may need the answers at some point, so I urge you to hurry up. If it's not me who is going to be affected by this, it's certainly all my buddies.
7:50 p.m.
Mr. Peter Fonseca (Mississauga East—Cooksville, Lib.)
We can't thank Dr. Chris Nowinski enough, and Mr. Eric Lindros, for coming in.
You have been excellent witnesses. On behalf of all the members, we thank you for your passion, your advocacy, the research you are doing and the collaboration with Canada. Thank you.
We are looking to have this study completed by the spring, and we'll present you with the report.
7:50 p.m.
Chief Executive Officer, Concussion Legacy Foundation
It has been my honour. Thank you.