EM - Team doctor

[slick177]

Just wondering if there are any EM physicians out there that function as a team doctor. I am mostly interested at the local (high school/small college) level and not necessarily the professional/D1 level. In my experience it has been FPs/Peds/Sports Med who provide this coverage, but it seems that you would be adequately trained as an EM physician.

Thanks for your input.

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[docB]

I'm a team doctor for a professional hockey team and several of my partners are fight docs (which is a busy gig here in Vegas). It's fun. An EP is trained to deal with whatever might happen during a game but we need back up from ortho and an actual sports med doc for the longer term management of stuff. A good example is consuccion. An EP doesn't really care about the after care. A team doc has to know when and if that player can start playing again.

 

[anonymousEM]

Many residencies are involved in some sort of sports medicine. In my residency we had opportunities to do some event medicine--races, the Superbowl, police vs. fire (guns and hoses ) boxing, and other community events. Also I was a HS team doc for a HS football team and went to all of the home games through the department. This was coordinated through ortho and they would work with anyone I referred but my site was EM docs, other schools in the league were covered by ortho or FM docs from our hospital. Team medicine is definitely do-able as a resident, academic or community doc. Many more opportunities at the volunteer level but some paying ones are out there too...

 

[chuck deli]

I'm a team doctor for a professional hockey team and several of my partners are fight docs (which is a busy gig here in Vegas). It's fun. An EP is trained to deal with whatever might happen during a game but we need back up from ortho and an actual sports med doc for the longer term management of stuff. A good example is consuccion. An EP doesn't really care about the after care. A team doc has to know when and if that player can start playing again.

Boy, the dreaded "consuccion", I wouldn't even know what to do about that, definitely have to turf that to the orthopods. Now, a concussion I could handle. Sorry, slow day at work today, to the point that spelling-humor is hilarious to me.

 

[Tiger26]

So I always kinda wondered what are the liability issues involved here? Just thinking about some parent suing for future earnings because little bobby was going to get a scholarship and then turn pro where he would make ________xmillions of dollars and now that's all ruined because you as the team doc didn't fix his ACL out in the middle of the field or diagnose some extremely rare disease.

 

[jbar]

how would the liability be any worse than having the same kid present to you in the ED? You do an exam, and the kid who you would send to X ray in the ED you send to the hospital to get an X ray. Besides, as someone above said, you aren't doing definitive care on these people unless you've specialized in sports medicine. You stabilize the injury, make sure they aren't dying, and send them to the hospital.

 

[Egon]

Most sports medicine fellowships in FP will take EM as well.

The best way to be a team doc is to do the year fellowship through EM or FP and get certified. With that said, most of what you do is watch the game...

In residency at Sinai we covered the Mets game as "event" medicine. We took care of the drunks who fell down the stairs or old guys having CP after eating the third hot dog. (They have trainers on the field if the players pull a hammy.)

 

[Flopotomist]

how would the liability be any worse than having the same kid present to you in the ED? You do an exam, and the kid who you would send to X ray in the ED you send to the hospital to get an X ray. Besides, as someone above said, you aren't doing definitive care on these people unless you've specialized in sports medicine. You stabilize the injury, make sure they aren't dying, and send them to the hospital.

To play devils advocate here - why couldn't a paramedic do that? What is the point of the physician being there at all?

 

[jbar]

A medic could, and at many levels it is an EMT or medic at the game (high school, college etc) But for pro sports I assume it is a combination of lots of docs who want to do it and teams that say "we spent $4 million on this guy last year, we don't care if you say a medic can do the job, we want a doc there." Also sports with lots of injuries like football want an ortho MD eval right away (they even do xrays at the stadium) so they can figure out if the player can go back in or has to sit out. This is more of an ortho/sports med thing, for the emergencies there isn't much difference between what a medic would do and a EM doc in the field. I was just pointing out above that the liability for a doc on scene shouldn't be much greater than seeing the same pt in the ED.

 

[Tiger26]

One other thing I just remembered is that some of the big time, pro team sports med docs (ortho esp) don't even really make their money directly off treating the pro players.

A friend's dad works w/an ortho guy for an NFL team, and apparently the real money is being able to say "I do all the surgeries for ____team" so you should come to me as well for your 'weekend warrior/YMCA/playing out in the yard with the kids' types of injury.

 

[MedicFL]

Agreed with above I know two of the team DOC's for the magic and it isnt that big of a money deal. Its more about exposure.

 

[alphaholic06]

Agreed with above I know two of the team DOC's for the magic and it isnt that big of a money deal. Its more about exposure.

Don't most these guys actually pay the team for this privilege.

 

[docB]

We kind of merged event medicine with sports med over the last few posts. They are not the same thing. Most event med stuff is covered by Medics who transport when necessary. Some events use docs who either contract or volunteer depending on the event.

Sports med is treating the players (and the mascot, refs, equipment guy's kid etc.). The trainors deal with all the rehab stuff but they often need (maybe not need but request so they don't get on the hook for missing something) help in the initial assessments of new injuries. That's where the docs come in.

Many sports docs don't get a lot of money directly from their work as team docs. They get the prestige as mentioned before. In the minor leagues I've seen Orthos who work the gams for free but have a contract and get paid for any office visits and surgeries they do. I work games for free but bill when they have to go to the ED. In actuality I do that more for documentation than because I make any money at it. I really do it because I'm a fan.