As orthopedic surgeons and faculty members, we have an ethical and moral obligation to care for all patients. The recent opinion published by The Journal of Clinical Orthopaedics and Related Research that calls for orthopedic surgeons to recuse themselves from the sidelines at American football games is flat-out wrong. We must be on the sidelines to work for the safety and appropriate treatment of athletes.
The suggestion that it is a better practice to distance ourselves from football — that is, not “standing on the sideline” or not “performing sports physicals for high school and college players” — is without merit. Instead, this approach promotes fragmentation of care, jeopardizes athletes’ health, and is, in essence, withholding care, going against the oath we took. We must provide immediate treatment to those who suffer traumatic injuries and by our very presence prevent further injury.
The editorial ignores the hard work physicians do to safeguard athletes, and focuses instead on opinions about a business strategy. By its logic, American newspapers have a responsibility not to cover the sport, and FOX, NBC, ESPN and CBS, would stop broadcasting the games. None of that is our concern — our concern is keeping people who play sports safe.
We agree with the response in the Inquirer from Vincent Shaller of the Mid-Atlantic Concussion Alliance, who believes the editorial is short-sighted and fails to advance the cause of safety.
The significant failure of the editorial is that it doesn’t offer a strategy for prevention, for research, and for rules to protect athletes from concussion. As more evidence presents itself regarding the relationship between concussions and chronic traumatic encephalopathy (CTE), we as physicians should be guiding the protocols to safeguard players.
Specifically, we must be at the center of integrative solutions to provide football players with a safer environment in which to play. Engaging in community outreach projects, participating in sporting events, and bringing attention to the work done at organizations such as the Rothman Institute and Jefferson Comprehensive Concussion Center has enabled us to reach athletes, parents, trainers, coaches, therapists, youth sport organizations, board members, and other physicians. This gives us the opportunity to take a multidisciplinary approach to educating the public through seminars on concussion awareness, to create true safety partnerships, and to present cutting-edge research. Our continued presence in the community provides us the ability to counsel athletes on the risks and to provide them with the most current evidence, putting them in the best position to make informed decisions about participating in football.
At the Rothman Institute at Jefferson, we do not take lightly our obligations to our patients’ safety, and we remain committed to their health both on and off the field. Our support of the Eagles is not turning a blind eye to the issues of CTE, but quite the opposite. Our relationship provides the support necessary at the organizational level for the team to identify, treat, and potentially prevent any injuries or conditions professional athletes encounter.
The partnership between the Rothman Institute and the Eagles goes beyond the team itself. Many Rothman Institute physicians and surgeons render their expertise as team physicians at dozens of local high schools and colleges. Furthermore, the annual Rothman Institute at Jefferson Sports Medicine Symposium, in partnership with the Eagles, provides a free day of education and updates on sports medicine techniques, training, and injury prevention to college-level athletic trainers.
The journal editorial does not discourage or dissuade us from continuing our relationship with the Eagles, but encourages us to strengthen our resolve to provide and facilitate all aspects of care for professional athletes and continue our support and involvement in prevention and treatment of CTE.
It is not only responsible.
It is ethical.
Alexander R. Vaccaro, M.D., Ph.D., M.B.A. is president of the Rothman Institute. Stephen K. Klasko, M.D., M.B.A. is president and CEO of Thomas Jefferson University and Jefferson Health.