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Reply to the Letter to the Editor

Editorial

Do Orthopaedic Surgeons Belong on the Sidelines at American Football Games?

Leopold, Seth S. MD

Clinical Orthopaedics and Related Research®: April 2018 - Volume 476 - Issue 4 - p 913
doi: 10.1007/s11999.0000000000000182
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S. S. Leopold, Editor-in-Chief, Clinical Orthopaedics and Related Research®, Philadelphia, PA, USA

S. S. Leopold MD, Clinical Orthopaedics and Related Research®, 1600 Spruce St., Philadelphia, PA 19103 USA, Email: sleopold@clinorthop.org

(RE: Leopold SS, Dobbs MB, Gebhardt MC, Gioe TJ, Rimnac CM, Wongworawat MD. Editorial: Do Orthopaedic Surgeons Belong on the Sidelines at American Football Games? Clin Orthop Relat Res. 2017;475:2615–2618).

The author certifies that neither he, nor any members of his immediate family, have any commercial associations (such as consultancies, stock ownership, equity interest, patent/licensing arrangements, etc.) that might pose a conflict of interest in connection with the submitted article.

All ICMJE Conflict of Interest Forms for authors and Clinical Orthopaedics and Related Research® editors and board members are on file with the publication and can be viewed on request.

The opinions expressed are those of the writers, and do not reflect the opinion or policy of CORR® or The Association of Bone and Joint Surgeons®.

My coauthors and I thank Mr. Bates and colleagues for their thoughtful letter, and for continuing an important dialogue here following our earlier editorial [3].

We cannot know whether “a continued expansion of the sports medicine care team to encompass a broader array of specialties,” as suggested by the letter writers, would improve the health of football players. In particular, as I’ve written before [1, 2], I am especially uneasy with the idea that getting the answer to that question will require running an experiment that will risk the lives of another generation of ballplayers—an experiment for which no informed consent is possible. Likewise, in earlier replies in this space, I have made the commonsense case for why a surgeon who decides to abstain from walking the sidelines does not in any sense of the term abdicate his or her professional responsibilities [1, 2].

And I am quite content to throw my lot in with the 14% of Dartmouth students in Mr. Bates’s survey who decided—after the thoughtful program and educational discussion they hosted on the topic—that orthopaedic surgeons should not continue to work with professional football teams. Science and medicine are not democracies in the sense that we don’t arrive at right or wrong by vote counting. Time, and future experiments, will tell.

But more than anything else, I would like to compliment Mr. Bates, his student colleagues, and their faculty mentor (and Dartmouth team physician) Dr. Carr, on how they approached this problem. Too often, when faced with a challenging idea or contention, people retreat from the tension and seek the comfort of like minds. To their great credit, Mr. Bates and his colleagues did the opposite: They embraced the tension, reviewed the available evidence, sought out expert mentorship, and sponsored an open discussion on a difficult topic. Some even changed their minds in the process.

I was inspired by the example these students set, and I hope that others will be, too. In this time of increasing polarization—both political and scientific—these students set an aspirational standard for how we all might approach complicated, contentious subjects.

Although most of them ultimately disagreed with our editorial, their letter brightened my day.

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References

1. Leopold SS. Reply to the letter to the editor: Editorial: Do orthopaedic surgeons belong on the sidelines at American football games? Clin Orthop Relat Res. 2017;475:3112–3115.
2. Leopold SS. Reply to the letter to the editor: Editorial: Do orthopaedic surgeons belong on the sidelines at American football games? Clin Orthop Relat Res. [Published online ahead of print]. DOI: .
3. Leopold SS, Dobbs MB, Gebhardt MC, Gioe TJ, Rimnac CM, Wongworawat MD. Editorial: Do orthopaedic surgeons belong on the sidelines at American football games? Clin Orthop Relat Res. 2017;475:2615–2618.
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