Accessibility of the team physician

The transition to the care of the college student-athlete carries with it a number of adjustments. In private practice it is customary to make medical decisions and initiate therapies from the confines of the examination room. The doctor-patient relationship is the principal focus. Although this relationship remains paramount in college athletics, the world of concerned and affected parties dramatically expands. It is in this context that the authors explore the concept of access in the role of a team physician. To use what is becoming an over used cliché, what makes one a valued team physician is being "the right person, in the right place at the right time."     

Rowing: sport-specific concerns for the team physician

Rowing injuries occur mostly from overuse and are seen primarily in the back, rib, knee, and forearm. Many of these have a specific cause owing to the mechanics of the rowing stroke, which are discussed, as are sport-specific treatment strategies. Also discussed are specific injuries sustained on the rowing machine, emergency issues, and special population concerns.     

Balancing life as a team physician

This article reviews the author's ten commandments for a balanced life as a team physician: (1) Do the right thing, always, no exceptions; (2) It's better to be an advocate than curse your competition; (3) Don't demand respect from players and coaches, earn it; (4) Loyalty is the weakest of human values (5) Communicate: Team physicians must always be available to athletic training staff; (6) In order to hit the mark, one must aim a little higher; (7) Enjoy your role as team physician; (8) Remember the five A's--Availability, Ability, Affability, Advocacy, and Affiliation; (9) Dare to care; and (10) Don't forget your family and friends.     

The physician to a swimming team

The physician to a swimming team should organize a health support system that prevents problems through education and encourages prompt and appropriate treatment to reduce complications. The overall goal should be the optimal level of care necessary to enable the swimmers to reach their potential.     

Ethics and the professional team physician

The professional team physician may face ethical questions that are unique to the practice of sports medicine. There are numerous pressures that potentially may affect or interfere with ethical medical decision-making. The purpose of this article is to highlight some of these issues and to increase awareness of them for the practicing team physician and trainers and others involved in professional sports.     

Sideline preparedness for the team physician: consensus statement

The objective of the Sideline Preparedness Statement is to provide physicians who are responsible for making decisions regarding the medical care of athletes with guidelines for identifying and planning for medical care and services at the site of practice or competition. It is not intended as a standard of care and should not be interpreted as such. The Sideline Preparedness Statement is only a guide, and as such, is of a general nature, consistent with the reasonable, objective practice of the health care professional. Individual treatment will turn on the specific facts and circumstances presented to the physician at the event. Adequate insurance should be in place to help protect the physician, the athlete, and the sponsoring organization. The Sideline Preparedness Statement was developed by a collaboration of six major professional associations concerned about clinical sports medicine issues; they have committed to forming an ongoing project-based alliance to bring together sports medicine organizations to best serve active people and athletes. The organizations are: American Academy of Family Physicians, American Academy of Orthopaedic Surgeons, American College of Sports Medicine, American Medical Society for Sports Medicine, American Orthopaedic Society for Sports Medicine, and American Osteopathic Academy of Sports Medicine.     

Financial implications of serving as team physician

Time is the greatest negative financial burden that you accept as a sports medicine physician, because the only way to produce revenue as a physician is with your time. This cost measured in time of doing business as a team physician can be high. Unless being a team physician is very rewarding to you through personal satisfaction or the other intangible indirect benefits associated with the role, being a team physician may not be a good financial decision for you as a person and a physician, or for your practice and your family.     

Understanding the politics of being a team physician

The team physician landscape is littered with political land mines. In the high-stakes world of professional sports, the politics of each encounter and medical decision--from figuring out how to get hired, to setting up a communication chain of command, to treating visiting players, to fending off the media--must be identified, assessed, and resolved. Key information must be communicated according to the expectations and unique personalities of each owner, general manager, coach, trainer, and athlete. The best team physicians manage relationships, competing agendas, and politically charged circumstances as adeptly as they wield a scalpel.     

Establishing a new practice as a team physician

The role of a team physician is an integral part of establishing a new practice. Regardless of the type of practice one enters, the team physician role provides an opportunity to establish an early referral base to build the foundation of a successful practice. Although this comes with great responsibility and significant time commitments, the joy of developing your practice doing what you enjoy most, sports medicine, makes these drawbacks less perceptible. Using all your potential resources and keeping your eye on the ball will simplify reaching the goal of having a happy, healthy, and rewarding career.     

Trends for the future as a team physician: Herodicus to hereafter

Much has transpired in the world of sports medicine since Herodicus, a Thracian physician of the fifth century BC, rendered his foundational theories on the use of therapeutic exercise for the maintenance of health and the treatment of disease. Unfortunately, as basic knowledge advances, history abounds in inconsistencies in regard to the proper and most effective delivery of sports medicine. This article traces the development of sports medicine and its relation to high school, college, and Olympic sports over the last centuries, and provides glimpses into what the future of the field may hold.     

Educational opportunities and implications associated with the team physician

Teaching is one of the primary responsibilities of the team physician. After all, teaching and medicine are inseparable. Educating others is a challenging yet essential role of a team physician, and understanding the educational opportunities, responsibilities, and methods of creating a learning environment are essential qualities of the team physician. The successful teaching team physician is the one who accepts his role as an educator, understands the importance of involvement in the educational process at all levels, and is able to create an environment conducive to student learning, while at the same time serving as a valuable resource for patients, coaches, administrators, and the public.     

Strength training: What the team physician needs to know

Strength training has become an integral part of preparing for and participating in sports. Strength is one of the four components of athleticism, along with power, speed, and agility. Optimal strength training and conditioning workouts are best directed by a coach with formal training in this discipline. Unfortunately, many high school and some college programs do not have access to certified strength and conditioning coaches. This task often falls to the individual sport coaches and medical staff (athletic trainers and physicians). In this article we present a framework for practical strength training knowledge including the concepts of specificity, prioritization, periodization, and progressive overload. We also discuss concepts of the sports medicine team and its approach to training and conditioning. This framework will give physicians and other athletic heath care providers the basic information needed to design and implement a safe and effective strength training program.     

Equipment, drugs and problems of the competition and team physician

Physicians nowadays commonly attend sports competitions or journeys with a sports team. In some competitions the rules ensure the attendance of a physician. The team physician has to take care of all kinds of medical problems within the team, while the competition physician basically takes care of acute complaints. The competition physician must organise the medical coverage of both athletes and spectators, also taking into account medical emergencies. In addition he should inform the teams and spectators about the medical coverage. The team physician must also perform a precompetition health screening of individual team members, and take care of infection prophylaxis before and during journeys. Usually the physician carries drugs for respiratory infections, antibiotics, anti-inflammatory drugs, gastrointestinal medications, antihistamines, eyedrops, local anaesthetics and dermatological medications. The physician's bag should not include banned substances, other than specially labelled emergency medications. The inclusion of other medications and equipment and the need for other medical resources is highly dependent on the length of the journey, the destination, the type of sports, and the number of participants and spectators. Each sport has its characteristic injury profile and there are also sport-specific regulations which the physician must be aware of. Acute injuries are more common in contact sports, and overuse injuries in non-contact sports. In addition to musculoskeletal injuries, other conditions such as heat exhaustion and dehydration may be encountered, while cold can also cause special problems.