Sports Medicine: Just the Facts

•Negligence is the predominant theory of liability in med-
ical malpractice suits. It requires the following to occur:
a. Physician’s duty to the plaintiff
b. Violation or breach of applicable standard of care
c. Connection (causation) between the violation of
care and harm
d. Injury (damages) that can be compensated
•Physicians should have adequate coverage to defend
any case brought against them and to compensate any
judgments decided against them.
•Coverage may not be in effect if a physician is prac-
ticing beyond the scope of his or her expertise or in an
unlicensed area.
•Physicians traveling out of state or country with teams
should be aware of this possibility and check with
their malpractice carrier.

• Malpractice insurance should include an adequate tail
  to cover physicians when they change jobs

FALLACY OF THE GOOD SAMARITAN

• Good Samaritan doctrine: One who sees a person in
  imminent and serious peril through negligence of
  another cannot be charged with contributory negli-
  gence as a matter of law, in risking his own life or seri-
  ous injury in attempting to affect a rescue, provided the
  attempt is not recklessly or rashly made. Under this
  doctrine, negligence of a volunteer must worsen the
  position of person in distress before liability will be
  imposed. This protection from liability is provided by
  statute in most states (Nolan and Nolan-Haley, 1990).


• These laws and protection vary from state to state.


• These are a defense in a lawsuit and must be presented
  by your attorney as such.
  •A person expected to act, such as a team physician at
  a game, may not be covered by the Good Samaritan
  doctrine, whether compensated or not.


• The Good Samaritan doctrine should not be a substi-
  tute for adequate malpractice coverage.


• The doctrine should be adequate in most states to
  cover a physician who renders aid when an unex-
  pected medical situation arises, such as at an auto
  accident or if as a spectator at an event where another
  spectator has a cardiac arrest.


• Some jurisdictions may require a physician to provide
  care under these circumstances.

PATIENT (ATHLETE)—PHYSICIAN RELATIONSHIP

• The patient (athlete)–physician relationship should be
  one of mutual trust and teamwork.
  
  
  • The athlete (or parents or guardian if a minor) has
    rights to autonomy, self determination, privacy, and
    appropriate medical care.
    •Even if a minor, an athlete has certain rights to seek
    medical care in most jurisdictions for treatment
    related to pregnancy, drugs, and sexually transmitted
    disease. Check with local laws.
  
  
  • Privacy is a difficult issue owing to the public nature of
    athletic events—evaluation is done on the field or court-
    side. All attempts must be made to maintain privacy.
  
  
  • Professional and college organizations may consider
    waivers to allow certain information regarding athletic
    injuries or illnesses to be discussed with press repre-
    sentatives. Some organizations require reporting of
    injuries and illness (such as professional sports and
    some college sports). Care must be taken to avoid dis-
    closing information.
  
  
  • It is probably best to have an administrative person, such
    as a sports information director or public information
    officer, deal with the press to prevent the physician from
    inadvertently releasing private issues. If the physician is
    to talk with the press he or she should speak with cau-
    tion and only with the athlete’s permission.
  
  
  
  

DRUGS AND THE ATHLETE

MEDICATIONS: PRESCRIBING; DISPENSING

•Legal medications are generally divided into two

groups, prescription and over-the-counter (OTC).

Prescription medications are further divided into con-

trolled substances (narcotics, sedatives, and the like)

that have a higher potential for abuse and misuse and

standard prescription drugs (such as antibiotics, anti-

inflammatory medication, and medication for blood

pressure and diabetes).

• In some states, a special prescription is needed for dis-
  pensing of the highest level of controlled substances.


• Medication prescribing and dispensing falls under
  many laws including state medical laws, pharmacy
  laws, and consumer safety laws.


• In general a physician may prescribe medication or
  provide medications under the state laws which usu-
  ally include examination of the patient.
  •A licensed pharmacist may provide medication as pre-
  scribed by a licensed physician.


• There are generally strict labeling requirements often
  including the name of the patient, name and strength
  of the medication, directions for use, date dispensed,
  quantity dispensed, and warnings of common side
  effects. In addition, many states require the pharma-
  cist to counsel the patient on the medication.

10 SECTION 1 • GENERAL CONSIDERATIONS IN SPORTS MEDICINE