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Concussion clinics spread as risks worry parents

Dr. Michael O’Brien evaluates Brandon Williams at the Sports Concussion Clinic at Boston Children’s Hospital. O’Brien says that the study of concussions is still in its infancy.Charlie Mahoney/The New York Times/NYT

The drumbeat of alarming stories linking concussions among football players and other athletes to brain disease has led to a new and mushrooming American phenomenon: the specialized youth sports concussion clinic, which one day may be as common as a mall.

In the past three years, dozens of youth concussion clinics have opened in nearly 35 states — outpatient centers often connected to large hospitals that are now filled with young athletes complaining of headaches, amnesia, dizziness, or problems concentrating. The proliferation of clinics, however, comes at a time when there is still no agreed-upon formula for treating the injuries.

“It is inexact, a science in its infancy,’’ said Dr. Michael O’Brien of the sports concussion clinic at Boston Children’s Hospital. ‘‘We know much more than we once did, but there are lots of layers we still need to figure out.’’


Deep concern among parents about concussions is colliding with the imprecise understanding of the injury. To families whose anxiety has been stoked by reports of former NFL players with degenerative brain disease, the facilities are seen as the most expert care available. That has parents parading to the clinics.

The trend is playing out vividly in Boston, where the phone hardly stops ringing at the youth sports concussion clinic at Massachusetts General Hospital.

“Parents call saying, ‘I saw a scary report about concussions on ‘Oprah’ or on ‘The Doctors’ show or Katie Couric’s show,’ ’’ said Dr. Barbara Semakula. ‘‘Their child just hurt his head, and they’ve already leapt to the worst possible scenarios. It’s a little bit of a frenzy out there.’’

At Boston Children’s, patient visits per month to the sports concussion clinic have increased more than fifteenfold in five years, to 400. The clinic, once just two consultation rooms, now employs nine doctors at four locations and operates six days a week.


“It used to be a completely different scene, with a child’s father walking in reluctantly to tell us, ‘He’s fine; this concussion stuff is nonsense,’ ’’ said Dr. William Meehan, a clinic cofounder. ‘‘It’s totally the opposite now. A kid has one concussion, and the parents are very worried about how he’ll be functioning at 50 years old.’’

Yet doctors say the focus on the dangers of concussions is long overdue. Concerned parents are seeking better care, which has saved and improved lives. But a confluence of forces has also spawned a mania of sorts that has turned the once-ignored concussion into the paramount medical fear of young athletes.

Most prominent have been news media reports about scores of relatively young former professional athletes reporting serious cognitive problems and other later-life illnesses.

Several former NFL players who have committed suicide, most notably Junior Seau, a former San Diego Chargers and New England Patriots star, have been found posthumously to have had a degenerative brain disease linked to repeated head trauma.

And 43 states have passed laws requiring school-age athletes who have suffered a concussion to have written authorization from a medical professional before they can return to their sport.

“We are really in the trenches of a new medical experience,’’ said Richard Ginsburg, director of psychological services at Massachusetts General Hospital’s youth sports concussion clinic. ‘‘First of all, there’s some hysteria, so a big part of our job is to educate people that 90 percent of concussions are resolved in a month, if not sooner. As for the other 10 percent of patients, they need somewhere to go.


Paul McDonough of Quincy, whose daughter, Erin, is a high school hockey player and has had three concussions, said: ‘‘When you’re reading autopsy results of NFL players with head trauma, as a parent, it doesn’t make you very patient or put you at ease. That’s why we’re all going to specialists.’’

Erin saw Dr. Cynthia Stein at the Boston Children’s clinic. Stein routinely explains to patients that pro football players may have taken thousands of hits to the head in youth leagues, high school, and college — in addition to 10 or more years in the NFL

“Who knows how many concussions someone like Junior Seau really had?’’ Stein said. ‘‘And we don’t know why he died. It’s not an appropriate comparison. Our patients, if their concussions are managed properly, are going to heal on their own. The body knows how to take care of itself.’’

Are the clinics also profit centers?

Interviews with directors of clinics nationwide produced a consensus that they are not significant moneymakers because they are not procedure driven — meaning they do not typically lead to expensive imaging tests or operations. Instead, they tie up doctors in lengthy, multifaceted patient consultations.

But Michael Bergeron, executive director of the National Youth Sports Health and Safety Institute, said the volume of patients they attract could have residual benefits for the bottom line.

“Concussion clinics might be seen as a loss leader for the halo effect they bring the institution,’’ Bergeron said. ‘‘People recognize you as an authority offering a timely service that is very much in the news. It might make them consider you for other treatments, too. It’s another dimension to promote on your website.”