Outside The Lines

Thursday, September 12
Updated: September 17, 4:42 PM ET
Turn your head and scoff

By Tom Farrey

Players concerned about the quality of care they receive from NFL team doctors may soon have a form of recourse: They can initiate investigations into the medical staffs that could lead to the doctors' removal by an entity other than individual team owners.

O.J. McDuffie
O.J. McDuffie sued the Dolphins' team physician after his career ended.
League officials are having formal discussions with representatives of the players association about creating a procedure to stem the growing distrust between players and the doctors designated to service them.

"On some teams, a large number of players believe they don't have the best medical care that's available to them," said Harold Henderson, NFL executive vice president. "We believe that throughout the league, we should have the very best."

Two years ago, in a NFL Players Association survey of 1,152 players from around the league, the union members were asked to rate their teams' medical staffs. The results showed wide variance in the opinion that players have about their respective team doctors, with most medical staffs earning high ratings and a handful receiving low marks.

The Cincinnati Bengals' doctors were held in the lowest esteem, with only 19 percent of their players describing them as "good" or better. At the top were six teams -- Baltimore, Dallas, Denver, Oakland, Philadelphia and the New York Jets -- in which 100 percent of players expressed that level of confidence in their doctors.

The NFL and union are in discussions about conducting another, more comprehensive study on medical issues this season, to more precisely identify issues of concern.

Henderson said the league and union are "very close" to working out a new set of medical guidelines and procedures.

NFL team doctors ratings
Below are the percentage of players on each team who rated their medical staff as "good" or better, in an NFL Players Association survey taken during 2000. An asterisk indicates which teams went to the playoffs that year.
Rank Team Pct.
1. Baltimore* 100
1. Dallas 100
1. Denver* 100
1. N.Y. Jets 100
1. Oakland* 100
1. Philadelphia* 100
7. N.Y. Giants* 97
8. Pittsburgh 95
8. San Diego 95
8. Tennessee* 95
11. Cleveland 94
12. Miami* 93
13. Chicago 92
13. Green Bay 92
13. San Francisco 92
16. Tampa Bay* 90
16. New England 90
18. Seattle 87
18. Washington 87
20. Minnesota* 83
20. St. Louis* 83
22. Buffalo 76
23. Detroit 75
24. Atlanta 74
25. Carolina 72
26. Jacksonville 63
27. New Orleans* 61
28. Indianapolis* 58
29. Kansas City 55
30. Arizona 50
31. Cincinnati 19

"We're concerned about the standard of care and the consistency of care, not just with the doctors but the trainers," said Doug Allen, an NFLPA official.

The NFL has endured several high-profile medical problem situations in the past year. Most notable was a $100 million lawsuit filed by the wife of late Minnesota Vikings lineman Korey Stringer, who died from heat exhaustion after collapsing during a summer practice last year. Since then, former Miami Dolphins receiver O.J. McDuffie sued his former team doctor after his career ended due to a big toe injury, and former Jacksonville Jaguars lineman Jeff Novak had his suit against a former team doctor go to trial.

But players aren't the only ones agitating for change. Doctors say they are in a crisis situation as well, due to rising medical malpractice rates. Turmoil in the insurance industry has pushed the costs of coverage higher for many doctors in society, but NFL doctors say they are under even greater pressure because of the level of exposure that comes with treating athletes making millions of dollars.

"What if you're treating Randy Moss with his $80 million or so contract?" said Jon Browne, NFL Physicians Society president and head doctor for the Kansas City Chiefs. "There's no insurance contract that you could buy that would cover that potential liability."

The NFL doctors group would like to have teams pick up more of their insurance costs.

"Teams say they want the best doctors to work for them," said Elliot Pellman, the New York Jets' head doctor. "But I have no doubt that unless something changes, the best doctors aren't going to want to work for them anymore."

One area the union and NFL are focusing on is access to second medical opinions. Through the collective bargaining agreement, players already have the right to seek, at the team's cost, a second medical opinion. The team also must pay for any surgical procedure that a player chooses to have with an outside doctor.

But players say clubs often make it uncomfortable to request that option.

"We want to make sure there's no resistance from the coaching staff to getting a second opinions," Allen said. "We've got a provision for that but, frankly, players are often interfered with by the (team) doctor or the front office."

Players who don't trust their team physicians also have no ready resource to find quality specialists, instead relying on the judgment of their agents or teammates. To solve this problem, the league and union are discussing the creation of a jointly approved list of outside doctors in each NFL market who can serve players, Henderson said.

"We're hearing from players that they need to get second opinions because they're not confident in getting just one voice, one opinion," he said. "Yet, we're hearing from both sides -- players and team doctors -- that the people who are rendering these second opinions may not be expert, or even competent."

But establishing a greater level of trust with team doctors remains a paramount concern of the league and union. Although Henderson calls the NFLPA survey from two years ago "unscientific," a study of the ratings shows that the medical staffs that were most highly regarded by players were often from teams that have done well on the field in recent years.

There were anomalies at the top of the ratings -- Dallas went 5-11 during the year of the survey, and perennial also-ran San Diego, with a 95 percent of players rating their doctors as "good" or better, went 1-15 that year. But five of the top seven-rated medical staffs were from teams that went to the playoffs that year, including Baltimore, which won the Super Bowl.

It's very important for players to trust their team doctors just for the fact that when you're injured, it's the doctor's job to determine how serious the injury is. A lot of players are incapable of making a decision on whether to play or not.
Green Bay Packers linebacker Hardy Nickerson
By contrast, none of the 10 teams at the bottom of the ratings have won a Super Bowl in the past decade. All of which begs the question: Can a team win it all if its players don't have faith in its team doctors?

Hardy Nickerson, a Pro Bowl linebacker who has played with four teams (Pittsburgh, Tampa Bay, Jacksonville and now Green Bay) in 16 NFL seasons, said the relationship between players and team doctors should not be underestimated.

"It's very important for players to trust their team doctors just for the fact that when you're injured, it's the doctor's job to determine how serious the injury is," he said. "A lot of players are incapable of making a decision on whether to play or not."

Tom Farrey is a senior writer for ESPN.com. He can be reached at tom.farrey@espn.com

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