The American College of Sports Medicine (ACSM) is proud to feature Anthony I. Beutler, MD, in this issue’s Clinician Profile. Dr. Beutler is a faculty member in the Department of Family Medicine and the medical director of the USU Injury Prevention Research Laboratory. Dr. Beutler is an acclaimed international educator and researcher in sports medicine and musculoskeletal injury prevention. He directs the Tri-service military sports medicine fellowship in Washington, DC, and is the educational director for 12 sports medicine fellows in the National Capital Sports Medicine Consortium each year. He has authored numerous peer-reviewed publications and edited a sports medicine textbook, and has presented lectures around the world. Dr. Beutler is on the executive committee for multiple national and military organizations dedicated to improving the health and safety of military and civilian populations. As a member of the Consortium for Health and Military Performance (CHAMP) at USU, Dr. Beutler works to translate scientific knowledge into policies and clinical practice that optimize physical resilience in military warfighters. His research interests include anterior cruciate ligament (ACL) injury mechanisms, musculoskeletal injury mechanisms, posttraumatic arthritis, musculoskeletal education, sudden death in athletes, and exercise as a treatment for almost anything. He has been a member of ACSM since 2001.
What inspired you to pursue a career in sports medicine?
I first thought about being a physician when I was about 12 years old. Dr. Boyd Terry was a family friend and surgeon at University of Missouri-Columbia. Quite often during church services, Dr. Terry’s pager would go off. These were the old days, before silent, vibrating pagers—and he was always the last member of the congregation to realize that his pager was going off—so it created quite a stir. I’d always wait, half-holding my breath, because if it wasn’t something too serious, sometimes Dr. Terry would poke his head back into the chapel and motion for me to come with him to the hospital, which I absolutely loved! So, I suppose you could say that I first considered being a physician as a way of getting out of church!
Sports medicine came later. I’ve always been an active, athletic, mechanically inclined guy who likes to work with his hands—so I went to medical school to “rule out orthopedics.” I had a fantastic experience working in the Mike Krzyzewski Human Performance Lab with Dr. William Garrett, who was a very important early mentor to me. But what really sealed the sports medicine deal was my family medicine rotation to Travis Air Force Base. At Travis I met a team of doctors who were fantastic physicians, but they also did vasectomies, sigmoidoscopies, colposcopies, skin procedures, and all the non-operative fracture management with casting for the entire hospital. I fell in love with the idea that I could be a comprehensive family doc AND do sports medicine. And I have so enjoyed the chance to do this in the Air Force!
What was it like to be a clinician a decade ago compared with today?
A decade ago sport physicians were just starting to use ultrasound and just starting to think about proinflammatory or regenerative therapies. So I ordered a lot more MRIs and I referred a lot more patients for surgery. We had eccentric exercises for tendinopathy and we were recognized as important exercise physicians for athletes with asthma, CAD, and other complicated medical conditions. But as a sports medicine doctor 10 years ago, I sometimes felt like I was just trying a bunch of different exercises and hoping that people would get better before I had to refer them off for definitive surgical treatment. Today, my practice is a lot more balanced. I still send a few patients for surgery, mostly for acute injury, but we have so many more options for tendinopathy and fasciopathy. We have more options for osteoarthritis (though we certainly still need better options here). We have botox for chronic exertional compartment and thoracic outlet syndromes. And we have ultrasound that allows us to deliver diagnostic and therapeutic injections precisely and to regions that were unthinkable 10 years ago. I really enjoyed sports medicine 10 years ago. I absolutely love it now, and I hope I’m still alive and kicking 10 to 20 years in the future to see all the new things we’ll have to offer our patients then.
What is your best advice to other sports medicine clinicians?
My best advice is to be a good doctor first. Musculoskeletal and exercise problems are fascinating and often really important. But the most important thing is to take care of the total person in front of you, and to never lose sight of the fact that they are a real person with a life and a family, and things they care deeply about. As an example, I recently sent my father to see one of my sports medicine colleagues. I was concerned that he had an insufficiency fracture of the hip or maybe even metastatic prostate cancer. My colleague guided my dad through a fairly complicated workup and ended up diagnosing him with Paget’s Disease of the bone. It was a much better diagnosis than metastatic cancer—but more important than the diagnosis was the care and attention that my dad received. He doesn’t like doctors and really doesn’t trust them (I suppose this tells you something about me), but he was so impressed with my sports medicine colleague and would be happy to go back and see him anytime.
What is the most common question you are asked as an Air Force Sports Medicine doctor?
When people hear I’m an Air Force sports medicine physician, they usually look confused and always ask the same question: “So, do you take care of the Air Force Academy football team?” When you think about it, that’s a silly question because I live in Washington, DC, and the Air Force Academy is in Colorado Springs, some 2000 miles and two time zones away!
But as an Air Force sports medicine doctor, I take care of the largest and most highly trained sports team in the world. Everyday 1.3 million active duty warfighters wake up early and think of new and exciting ways to hurt themselves! And when they are successful in this quest, it is a privilege to help them get back to full fighting strength. But even better than treating injury is the chance to prevent injury, exercise-related illness and mortality. There are so many great things about being a military doc! I’ve loved the opportunity to move seamlessly between jobs in research, education, and clinical medicine. Working with our small team of sports docs across the Air Force, Army, Navy, and other uniformed forces, I think we HAVE made a difference in decreasing injury, improving training, and in educating the next generation of military sports docs who will solve the next generation of musculoskeletal problems! But the very best thing about being a military sports physician is the chance to be on the same team with the brave men and women who put their lives on the line for each of us every day. To wear the same uniform and have the opportunity to take care of these warfighters, their family members, and the retirees who came before—that is the absolute best thing about being a military sports physician.