physician recommendations: how long will the player
miss class or be in the hospital. They seldom need to
know medical or personal details of the athlete’s situ-
ation. Remember that the athlete’s confidentiality is
the first concern. Members of the media rarely, if ever,
need information from the team physician.
•Well-defined criteria for dealing with the media should
be established. If a team physician is encouraged to
participate in an interview, insist that written questions
be submitted before-hand so that appropriate remarks
can be constructed for the record. These planned
responses can be reviewed with team coaches, trainers,
and administrators to ensure their consistency, accu-
racy, and regard for the athlete’s privacy.
•A team physician may need to discuss an athlete’s med-
ical condition with his parents, especially if working
with minors. It may be beneficial to send a letter to
parents prior to the season, describing the role of the team
physician and the continued importance of their personal
primary care physician to the athlete’s overall health.
- As mentioned above, the team physician coordinates
specialty care as medically indicated. In doing so, he
or she should provide the pertinent information neces-
sary to the respective medical consultant’s care and
receive written documentation of recommendations
from medical specialists.
OTHER CONSIDERATIONS FOR THE
TEAM PHYSICIAN
- Sports medicine abounds with opportunities for
research. Simply keeping accurate epidemiologic and
injury data has the potential to impact training regi-
mens, competition rules, or mandates for protective
equipment (Rice, 2000).
•Every would-be team physician must research the
medical liability risk and insurance coverage associated
with the position. A written contract or memorandum
of understanding with the institution or team that
defines responsibilities and level of coverage expected
is essential—even if no compensation is to be
received (Rice, 2002). Good Samaritan laws exist in
many states but the exact law varies widely between
different jurisdictions. Most Good Samaritan laws
apply only if the physician is receiving no compensa-
tion for his or her services. Compensation may be
defined by a specific dollar amount, or as little as
receiving a team shirt to wear at games! - Compensation as a team physician is variable. Almost
all work with teams competing at less than collegiate
level is voluntary. Deferring offers for nominal remu-
neration in favor of paying a trainer’s salary can be a
beneficial and time saving option (Rice, 2002). Most
team physicians work with athletic teams solely for
professional and personal satisfaction owing to their
interest in sports and athletes.REFERENCES
Each of these consensus statements is published by multi-
ple organizations. They may be downloaded or viewed free
at http://www.acsm.org/publications/consensusstatements.htm
Herring SA, Bergfeld JA, Boyd J, et al: Sideline Preparedness for
the Team Physician: A Consensus Statement. American Academy
of Family Physicians, American Academy of Orthopedic
Surgeons, American College of Sports Medicine, American
Osteopathic Academy of Sports Medicine, 2000a.
Herring SA, Bergfeld JA, Boyd J, et al: Team Physician Conse-
nsus Statement. American Academy of Family Physicians,
American Academy of Orthopedic Surgeons, American
College of Sports Medicine, American Osteopathic Academy
of Sports Medicine, 2000b.
Herring SA, Bergfeld JA, Boyd J, et al: The Team Physician and
Conditioning of Athletes for Sports: A Consensus Statement.
American Academy of Family Physicians, American Academy
of Orthopedic Surgeons, American College of Sports Medicine,
American Osteopathic Academy of Sports Medicine, 2001.
Herring SA, Bergfield JA, Boyd J, et Al: The team physician and
return-to-play issues: A consensus statement. Med Sci Sports
Exer34:1212–1214, 2002.
Melion MB, Walsh WM, Shelton GL:The Team Physician’s
Handbook, 2nd ed. Philadelphia, PA, Hanley & Belfus, 1997,
pp 1–7.
Rice SG: The high school athlete: Setting up a high school sports
medicine program, in Mellion MB, EWalsh WM, Madden C,
et al (eds.): The Team Physician’s Handbook, 3rd ed.
Philadelphia, PA, Hanley & Belfus, 2002, pp 67–77.
Rice SG: Development of an injury surveillance system: Results
from a longitudinal study of high school athletes, in Ashare AB
(ed.): Safety in Ice Hockeyvol. 3, ASTM STP 1341. West
Conshohocken, PA, American Society for Testing and
Materials, 2000, pp 3–18.2 ETHICAL CONSIDERATIONS IN
SPORTS MEDICINE
Ralph G Oriscello, MD FACC, FACPINTRODUCTION- Ethics in general is the conforming to accepted stan-
dards of conduct. No one achieves ethical perfection but
sports physicians are good by nature and guided by high
4 SECTION 1 • GENERAL CONSIDERATIONS IN SPORTS MEDICINE