CONFLICT OF INTEREST: Professional Team Doctors No Guarantee Of Top Medical Care

There is a common misperception among sports fans and the public that the very best physicians are providing the medical care for their favorite sports teams. An investigative article by the New York Times shed some light on exactly how a medical group “earns” the right to cover a sports team: THEY PAY FOR THE PRIVILEGE. ”People believe if a team doctor or an official hospital is good enough for their favorite athletes, then it must be good enough for their favorite athletes, then it must be good enough for them,” said Dr. William O. Roberts, president of the American College of Sports Medicine. ”But the purchasing power of these groups doesn’t necessarily reflect their abilities.”

”These arrangements suggest the medical care is not based on a person’s expertise but on the depth of his pockets,” said Gene Orza, the chief operating officer of the Major League Baseball Players Association. ”Our players do not like this trend in medical-care agreements one bit.”

Trying to alleviate any perceptions of conflict of interest, several teams that had entered into sponsorship agreements subtly amended them. Generally, the amount of money paid to the teams did not change. The teams were still paid $500,000 to $1.5 million by the medical providers; but instead of accepting physicians’ care without charge, the teams began to pay the doctors, though at a significantly discounted rate.

”People can say it’s a wash of money, but the fact is we now have a medical contract separate from the marketing contract,’‘ said David Cassidy, director of marketing for the Jewett Orthopaedic Group, which has had a sponsorship contract with the Orlando Magic of the N.B.A. that was revised four years ago to have the Magic pay the doctors it uses. ”The underlying theme that we were purchasing the right to be the team’s doctors was a negative connotation that we wanted to creatively circumvent.”

More recently Slate Magazine outlined “Why NFL team doctors are ethically compromised.”

The Ravens and 49ers are among the 23 NFL teams with “official” health care providers. (That figure is a hand count that the league declined to confirm.) These arrangements differ, but the standard deal includes reduced-rate medical care and/or a payment from the hospital to the team in exchange for the medical provider getting to ballyhoo the affiliation in its marketing. “The halo effect is huge,” Lew Lyon, vice president of the Ravens-affiliated MedStar Sports Medicine, tells me. “Friends will call me and say, ‘Can you get me into see one of the Ravens docs?’ And they’re very accessible. They have private practice like other physicians.” 

Click here to watch a video about How to Choose a Surgeon for Your Shoulder Replacement.

The expansion Carolina Panthers and Jacksonville Jaguars signed the first known medical sponsorship deals in the mid-‘90s. Since then, health care providers have been cutting deals with teams for the right to advertise themselves as the franchise’s “official” choice—even paying millions for those marketing rights.

Perhaps no conflict was as glaring as that of the Boston Red Sox when Arthur Pappas, the team’s longtime orthopedic surgeon, was also part-owner. Marty Barrett, a player and a patient, tore his ACL during the 1989 pennant race, and later won a suit against Pappas in which the player claimed that the doctor/owner disclosed to Barrett neither the extent of his injuries nor the time needed for proper recovery. A 1995 Sports Illustrated report on Pappas and other team docs cited a Chicago Bears doctor who botched a knee operation and then tried erasing part of a videotape of the surgery so as not to lose his contract with the team. No less than Bill Walton, Dick Butkus, and Carlton Fisk also believe their injuries worsened when team physicians hustled them back into the lineup. (Pappas was Fisk’s doctor as well.)

This story from USA Today outlines some of the challenges faced by players in the San Diego Chargers organization:

The San Diego Chargers’ head team physician has an extensive history of malpractice complaints from patients, including three who successfully sued him for awards that totaled $8.2 million.

The California state medical board also fined David Chao for misconduct in 2002 and issued a public reprimand against him in June 2012 for failing to disclose a drunken-driving conviction. The state board is moving to suspend or revoke his medical license, citing gross negligence in his care of patients.

Professional athletes now routinely obtain a second, third, or even fourth opinion and often travel long distances to have any necessary surgical procedures performed by a physician of their own choosing, when this is allowed. Sports fans and the public should take a cue from these athletes and do some research and get a second opinion or travel to get the very best medical care.

 

Author
Vivek Agrawal, MD

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