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Being a Team Physician

Callender, Shelley, Street, MD

Current Sports Medicine Reports: February 2018 - Volume 17 - Issue 2 - p 39–40
doi: 10.1249/JSR.0000000000000448
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Concussion Navicent Health Center, Mercer University School of Medicine, Macon, GA

Address for correspondence: Shelley Street Callender, MD, Concussion Navicent Health Center, Associate Professor, Pediatrics and Family Medicine, Mercer University School of Medicine, 700 Pine St., Macon, GA 31201; E-mail: Callender.Shelley@navicenthealth.org. Column Editor: Nailah Coleman, MD, FACSM; E-mail: ncoleman@childrensnational.org.

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Being a Team Physician

Being a team physician is a challenging and rewarding experience. Several variables impact the scope of practice for the team physician (i.e., level of competition, the sport governing body, or the venue of the competition).

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Qualifications

In most instances, it is advantageous to have a physician who has successfully completed and obtained board certification in a primary care or orthopedic surgery residency program and a formal sports medicine fellowship program (1,2). It is imperative that the team physician has an unrestricted medical license (MD/DO) and cardiopulmonary resuscitation certification. In addition, it is critical he/she have a fundamental and working knowledge of medical, musculoskeletal, psychological, and on-field emergency care related to sports medicine. He/she should regularly be involved in sports medicine continued educational endeavors (1,2).

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Liability

Sideline physicians should ensure their medical liability provider has coverage inclusive to team physician activities, because many states do not provide protection to the “team physician” through Good Samaritan laws (1).

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Medical and Administrative Responsibilities

Although there is some overlap, the responsibilities of the team physician can be grouped in relationship to the timing of event coverage.

Pregame/Preseason Preparation and Injury and Illness Prevention (2–4):

  • develop and implement the emergency action plan (EAP);
  • distribute, practice (annually), and review the EAP;
  • access athlete emergency documents;
  • coordinate game day injuries/illness assessment and management;
  • define sideline medical coverage role, authority, and responsibilities;
  • maintain effective communication skills and appropriate interactions with media;
  • recognize the importance of the preparticipation physical evaluation (PPE);
  • review/perform the PPE with acceptable forms in appropriate time frames;
  • understand the medical management, medical policies, and prevention of injuries/illness in athletes;
  • recognize components (i.e., nutrition, weight training, and so on) that affect athletic performance;
  • understand the unique concerns of certain athletic populations;
  • develop an agreement of responsibilities among the team physician, organizing body, and athletic care network;
  • ensure compliance with occupational safety, health administration, and local, state, and federal governing bodies;
  • understand the medicolegal components of sports medicine; and
  • provide education and scholarly activities related to sports medicine.

Game Day-Sideline Preparation (1,2,4,5):

  • review the EAP;
  • diagnose and treat sports-related conditions;
  • plan the medical care of athletes with the opposing team’s medical staff;
  • make the final decision on return to play (RTP);
  • ensure commonly utilized equipment is easily accessible;
  • complete pregame preparations (i.e., arrive early);
  • observe the event from an appropriate location;
  • be aware of the event conditions and environment;
  • identify treatment sites;
  • ensure adequate function of communication equipment;
  • ensure emergency supplies (i.e., AED) and personnel are available throughout event;
  • ensure personnel are aware of event-specific rules; and
  • maintain medical records.

Postseason and Nongame Day Considerations (1,3,4):

  • establish a postseason meeting with the athletic medicine team, administration, and necessary personnel;
  • establish a RTP process with an annual review;
  • establish a chain of command for injury/illness RTP;
  • establish the overall health status and the participant risk;
  • communicate RTP to the necessary personnel;
  • establish/review system for medical documentation;
  • understand governing body, local, state, and federal regulations to participation; and
  • integrate medical expertise, consultation, and interventions with the athletic network and make final decisions on subsequent day RTP.
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Travel Considerations (1):

  • coordinate supplies with the certified athletic trainer (ATC);
  • avoid transporting controlled substances across state lines;
  • declare availability to the host school athletic medicine team;
  • understand the host school EAP and location of emergency devices;
  • recognize there may be issues with practicing medicine in another state and investigate medicolegal coverage before travel; and
  • know the location of the nearest hospital(s), pharmacies, and their hours of operation.

The author declares no conflict of interest and does not have any financial disclosures.

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References

1. Gomez JE, Landry GL. Being a team doctor. Adolesc. Med. State Art Rev. 2015; 26:1–17.
2. American College of Sports Medicine. Team physician consensus statement—2013 update. Med. Sci. Sports Exerc. 2013; 45:1618–22.
3. American College of Sports Medicine. The team physician and the return-to-play decision. Med. Sci. Sports Exerc. 2012; 44:2446–8.
4. Courson R, Goldenberg M, Adams K, et al. Inter-association consensus statement on best practices for sports medicine management for secondary schools and colleges. J. Athl. Train. 2014; 49:128–37.
5. American College of Sports Medicine. Sideline preparedness for the team physician. Med. Sci. Sports Exerc. 2012; 44:2442–5.
Copyright © 2018 by the American College of Sports Medicine.