The Evolving Landscape of College Sports Medicine: Risks and Responsibilities

The professionalization of college sports has ushered in a new era, one that brings with it both exciting opportunities and significant challenges. As college athletes are now allowed to profit from their name, image, and likeness (NIL), the implications for team physicians and medical staff are profound. This shift raises concerns about potential legal liabilities and the evolving dynamics of athlete-caregiver relationships.

The New Reality of NIL

Since July 2021, college athletes have been able to enter into lucrative agreements with third parties, leading to multimillion-dollar contracts for some. This newfound financial potential has changed the stakes for everyone involved in college athletics, particularly team physicians. Previously, lawsuits alleging malpractice would have been nearly impossible to win, given the lack of guaranteed future earnings for college athletes. However, with the introduction of NIL, the landscape has shifted dramatically.

Dr. James Borchers, a prominent figure in sports medicine, highlights the complexities that now face clinicians. The fear of being sued by an athlete claiming that a medical decision negatively impacted their earning potential is a growing concern. As Borchers notes, the stakes are higher than ever, and some medical professionals may reconsider their involvement in college sports due to these pressures.

High-Profile Cases and Their Implications

The case of former Philadelphia Eagles player Chris Maragos serves as a cautionary tale for the sports medicine community. In 2023, a jury awarded Maragos $43.5 million after he alleged improper care for a knee injury, a ruling that sent shockwaves through the industry. The orthopedics group involved severed ties with the Eagles, fearing similar lawsuits in the future.

While no malpractice lawsuits have yet emerged at the college level, the potential for such claims looms large. Athletes could argue that suboptimal medical treatment hindered their ability to earn NIL money or transfer to more lucrative programs. This shift in perspective could lead to a new wave of legal challenges that team physicians must navigate.

The Liability Landscape

In the realm of college sports, team physicians typically work for university-affiliated medical centers or local medical groups, while athletic trainers are employed by the athletic department. This separation of roles complicates the issue of liability. Team physicians are required to carry malpractice insurance, but the standard coverage limits may not be sufficient in the event of a lawsuit. As Mike Matray, editor of Medical Liability Monitor, points out, an athlete’s economic damages could easily exceed the typical $1 million per incident coverage.

In response to these concerns, some team physicians are considering increasing their liability insurance limits. Dr. Jon Divine, head team physician at Cincinnati, notes that discussions are underway among Big 12 team doctors regarding the need for higher coverage. Additionally, the evaluation of injuries has become more rigorous, with many physicians opting for more advanced imaging techniques to ensure accurate diagnoses.

Changing Dynamics in Athlete-Caregiver Relationships

The relationship between athletes and team physicians has evolved significantly in recent years. Dr. David McAllister, head team physician at UCLA, observes that the trust-based dynamic has shifted toward a more transactional and sometimes adversarial relationship. In the past, athletes often formed lasting bonds with their medical staff, but the current landscape, influenced by agents and business managers, has altered this dynamic.

As athletes prioritize their earning potential, the pressure on team physicians has intensified. The traditional model of care, built on trust and long-term relationships, is being replaced by a more transactional approach, where medical decisions are scrutinized through the lens of financial implications.

Conclusion

The professionalization of college sports has introduced a myriad of challenges for team physicians, from potential legal liabilities to changing relationships with athletes. As the landscape continues to evolve, medical professionals must adapt to these new realities while ensuring the health and well-being of the athletes they serve. The future of college sports medicine will depend on navigating these complexities with care, compassion, and a commitment to ethical practice.