POTENTIAL FOR DIVIDED LOYALTIES

While rare in high school and uncommon in college
sports, there is major distrust between professional
athletes and team physicians (George, 2002).


Athletes may feel that there are too many instances
when the quality of their treatment is often secondary
to the doctor’s obligation to team owners and coaches.


A salaried position can interfere with the traditional
doctor–patient relationship.


To many the role of the salaried physician leads to a
conflict of interest. Such a conflict exists when the
employed sports physician’s objective professional
duties are compromised by personal interests, e.g., the
financial reward of his or her association with a professional
team as well as the publicity and high visibility
one gets from such a position.


It is an ethical breach for anything but the athlete’s
health interest to be considered, again, recognizing
judgment errors in too conservative or too liberal therapy
can occur.


The ultimate welfare of the athlete may seem in conflict
with the wishes of parents or spouse, coaches or
team management. The fact that an organization or
someone other than the athlete pays the physician is
immaterial. The loyalty of the sports physician is to
the continued healthy physician–patient relationship.


Decisions must be made solely based on sound medical
judgment. A reasonable third party, e.g. a university
or professional team, will understand this. If it
does not, the physician should remove his or her services
from that party.
• Occasionally, wishes of the athlete-patient conflict
with what the physician believes are in the athlete’s
best interest. If after negotiation and additional consultation
the sports physician feels uncomfortable
with another’s recommendation, continued care of
the athlete-patient could be difficult or impossible.
The athlete should be reassigned to another physician.


For the professional athlete, the unfavorable mix of
high salaries and short careers can make for risky
decision making by both the athlete and the physician.
Coaches often encourage physicians to rush players
back on to the field to win games. Players themselves
often desire to rush back too quickly.


Teammates should not be allowed to pressure injured
athletes by suggesting they are malingering while collecting
a substantial income. Under these circumstances
many physicians play by the rules of the
coaching staff.


An untimely death or worsening injury sets the stage
for lack of trust in the team physician.


By actions alone, the team physician demonstrates
that his or her utmost responsibility is to protect the
players. If a player should not be on the playing field,
that players will not be there.