Professional sports are a vast cultural phenomenon, a weekend pursuit, and a fun pastime for much of America. But behind the scenes, they can contain many unexpected ethical challenges that the fan may never consider. Medical teams for professional franchises have a much-envied position. However the professional and emotional pressures are often understated when one looks at the potential conflict of interest inherent in their position. In daily life when a patient is seeking treatment, their physician has complex decisions to make regarding risks and benefits of treatment options, what the patient wishes, and how the intersection of the two will affect the patient’s life. In the case of a team physician working for a professional sports team, however, the decisions can be much more complicated.
The major problems and source of conflict of interest that arise in the work of a team physician come from the decision about when an athlete may compete after or even with an injury. In an ideal world, the decision would be based only on what is best for the injured person. However, under the pressures of a professional sports team, a team physician could easily be blinded by the floodlights and/or management directives, and jumble the player’s needs as a patient with the player’s needs as an athlete. While a patient is defined by illness or injury, related concerns, and wishes for the treatment, the athlete is defined by free throw percentage, salary size, goals scored, or passing yards, their position, their impact on the game, and what they can do for the organization. This is further complicated by the athlete’s wish to compete, and the possibility of them masking or denying symptoms or pain. The coaches’ wishes and the physician’s recommendations should balance each other in the pursuit of a healthy, successful team. However, the way a professional sports team has been traditionally run prevents this parity.
A professional sports team is primarily a business. This means that those in management are focused on generating revenue, typically by way of wins. They make major decisions through the lens of creating a profit for the betterment of their business. When it comes to treatment of injured athletes, this can become a problem. Decisions regarding an injured athlete’s ability to play are made by the medical team. However, because the medical team works for the organization, there is a major incentive for them to please their employers. Any sports fan knows star athletes can be game-changers. One person could be the difference between a win and a loss, and depending on the game, is a difference that could cost millions of dollars. If making millions for a team depends on an athlete playing a specific game, and if the individual who determines whether or not the injured athlete may play is employed by the business, then there is a serious conflict of interest for the team physician.
It should be noted that a conflict of interest is defined as a situation in which a person’s decisions might be influenced by their other personal interests. Recognizing this conflict is not to say that all team physicians, or even any, would put their relationship with the business team before the health of their patients or even that their managers would ask them to. That being said, recognition of the potential for compromised decision-making is essential. Physicians should not have to juggle concerns about keeping their job and doing what is best for their athlete, honoring their own personal ethics and adherence to the code of conduct for their profession. But in giving their best medical advice, team physicians may have to ignore several things: the wish of the athlete, the wish of the coach, and even the subjective wish of themselves, as fans and employees. Otherwise, they risk sending the athlete back into the game before he or she is physically ready to compete.
Jennifer Norris is a full-time student in the Einstein-Cardozo Master of Science in Bioethics program (M.B.E.). In 2012, she graduated with a B.S. in Exercise Biology from UC Davis. Her background as an intern in athletic training and emergency medical research inspired her pursuit of bioethics. She graduates from the M.B.E. program this summer and is applying to osteopathic medical school.