All three divisions of the NCAA membership will consider legislation at January’s convention that would require all schools to designate a team physicianto oversee medical services for injuries and illnesses related to a student-athlete's participation in intercollegiate athletics.
The proposal, which was sponsored by the committee on Competitive Safeguards and Medical Aspects of Sport, has sparked discussions throughout the membership about what would be required and how it might affect their daily operations.
NCAA.org recently asked Lewis & Clark’s Acting Director of Athletics and Head Athletics Trainer Mark Pietrok and its Vice President, Secretary and General Counsel David Ellis many of the questions that members are currently asking at their own institutions. Their responses may not apply to every member, but they may be helpful to jump-start conversations on your campuses prior to the legislative vote on Jan. 18, 2014.
In your experience, what impact has the designation of a team physician at Lewis & Clark had on the health and well-being of your student-athletes?
David Ellis (DE): Thinking about it from the legal side, knowing that we have had our team physician review those protocols with our athletic trainer provides us additional protection in a situation where an athlete has been hurt on the field.
How long has Lewis & Clark had a designated team physician?
Mark Pietrok (MP): I’ve been at Lewis & Clark for twenty-five years. We’ve always had a designated team physician. The structure has changed over the years. It originally started out as two or three doctors that worked with us. They would come and cover our football games and the idea was we would refer students back to them when possible.
Its evolved over the years to now where I have an orthopedic and general practitioner. They’re at two different practices here in Portland that work as our team physicians. They now come on campus and see our students. Our orthopedics work with students on bone and joint issues. General practitioners see general medical questions for us or advise us, specifically in the concussion area.
We continue to refer out to where medical insurance is allowed. They’ve also started to use their positions with us as a teaching tool. Our general practitioner frequently oversees fellows. They come and work with us as well. It’s a long relationship that’s developed over time, but it’s been mutually beneficial to both parties.
If this legislation passes, would it have any effect on that relationship, as far as you can tell?
MP: None whatsoever.
What is the nature of your relationship with your team physicians? Are they volunteers? Are they part of existing medical staff? Are they medical staff from a university in town?
MP: Both of them are volunteers. There’s no money involved between the college and/or the doctors. The orthopedic works in his own private practice. The general practitioner is associated with the medical school, the medical hospital here in town, and part of that relationship is they have a sports medicine fellowship program where residents can finish up their residency, and if they wanted to spend an extra year studying sports medicine as it goes with general practitioners, they come in and do a fellowship.
Those fellows come and work with us, see our students, come to our games, and get that experience. It’s an educational piece at the medical school, which is a great relationship for us and that’s their benefit. Obviously, our benefit is their expertise in the world of medical general practitioners.
Are those relationships different from relationships you have with other contracted or volunteer university or athletics positions, like some of your coaches or adjunct professors?
DE: We have a number of volunteers at the College. I think these physician volunteers are slightly different, because they’re experts in their fields. Because of their expertise we hope it is not a huge amount of work for them to do what they do, but we do rely on their expertise.
Was legal staff involved with the athletic department in helping to establish the designated team physician relationship that you currently have?
MP: I would say that in our orthopedic team position he’s been with us about seven years. Before that, his partners were with us for twenty years. There was no legal counsel involved in the beginning. With our general practitioner, the medical school and the fellowship, there is a written contract. Over the years, however, lawyers have not been too involved.
DE: The relationship with the orthopedic doctor and his practice started before my time here, before the time of Lewis & Clark had a lawyer on staff.
Looking ahead, if this legislation goes through, do you see this impacting the legal landscape at Lewis & Clark at all?
DE: I don’t really. I think the current situation provides benefit to both. I think it works pretty well. I don’t see the fact of passing this legislation having any impact.
MP: The only thing I can see, which would have very minimal impact — like I said, our work with the orthopedic goes way back, and it’s always been an unwritten agreement. We may put it down in writing at some point and say what our doctor’s name is. We refer to him, he’s on our website and we refer to him as such but that would be the only thing I can see coming out of the work.
Beyond designating a team position, the legislation leaves the best practices up to each institution. You’ve talked a little bit about the relationship and how it has evolved. How has that relationship worked at Lewis & Clark?
MP: Like David said, these are relationships that are mutually beneficial. You need to look at it from that standpoint. Like any kind of relationship, as long as they’re mutually beneficial to each other they profit. If it’s a one sided relationship they’re going to fail. They need to look at how is this mutually beneficial for each side and whether it’s financial or, like in our case, where the relationship can be mutually beneficial but it needs to go well.
You’ve already addressed this a little bit. Why do you support this legislation?
MP: I’ll speak to it from my end, and then I’ll let David talk on the legal stand of it.
My profession in the world of sports medicine is changing quickly on a daily basis. Ten years ago we didn’t have any of the methods and customs in use right now. Now we have to have protocols. I think it’s critical as a licensed medical doctor that oversees our practices and our protocols as to how we go about doing our business. I’m not saying the doctor has to actually look at the student athlete.
They have to tell us, what are the best practices? What are the protocols? For Lewis & Clark it is extremely important in this day and age. Concussion is the great example, but there’s any number of different types of protocols. How do you deal with ACL and things of this nature and the protocols on rehab? It’s just really beneficial to have a medical doctor guiding you in that area.
DE: I can’t add much to that except that medicine is always evolving. The techniques and protocols for dealing with different kinds of injuries are always changing. I know Mark and his colleagues, as athletic trainers, keep up with that in their professional associations and continuing education, but it’s really nice to have a doctor also keeping up with those changes.Last Updated: Nov 19, 2013