Information Statement

Team Physician Definition, Qualifications, and Responsibilities: Consensus Statement

This Information Statement was developed as an educational tool based on the opinion of the authors. It is not a product of a systematic review. Readers are encouraged to consider the information presented and reach their own conclusions.

American Academy of Family Physicians, www.aafp.org; American Academy of Orthopaedic Surgeons, www.aaos.org,; American College of Sports Medicine, www.acsm.org; American Medical Society for Sports Medicine, www.amssm.org,; and American Orthopaedic Society for Sports Medicine, www.sportsmed.

The objective of the Team Physician Consensus Statement is to provide physicians, school administrators, team owners, the general public, and individuals who are responsible for making decisions regarding the medical care of athletes and teams with guidelines for choosing a qualified team physician and an outline of the duties expected of a team physician. Ultimately, by educating decision makers about the need for a qualified team physician, the goal is to ensure that athletes and teams are provided the very best medical care.

Five major sports medicine organizations were asked to select two representatives to serve on an expert panel. The organizations were the American Academy of Family Physicians (AAFP), the American Academy of Orthopaedic Surgeons (AAOS), the American College of Sports Medicine (ACSM), the American Medical Society for Sports Medicine (AMSSM), and the American Orthopaedic Society for Sports Medicine (AOSSM).

A panel of experts convened to develop a consensus statement on the definition of a team physician; the qualifications, duties and responsibilities of a team physician; and education strategies based on that statement. The process began with the panel agreeing on a definition of the team physician. The panel then worked to build consensus on each of the other topics. Throughout this process, care was taken to represent team physician responsibilities at all levels of athletic participation. These details have been consolidated into the Team Physician Consensus Statement.

Through discussion, the group concluded that clinical sports medicine issues, including team physician concerns, could be strengthened by the development of additional continuing education programs and future collaboration on a variety of topics. The panel united in the concept of forming an on-going project-based alliance to bring together sports medicine organizations to best serve active people and athletes.

I. Team Physician Definition

The team physician must have an unrestricted medical license and be an MD or DO who is responsible for treating and coordinating the medical care of athletic team members. The principal responsibility of the team physician is to provide for the well-being of individual athletes - enabling each to realize his/her full potential. The team physician should possess special proficiency in the care of musculoskeletal injuries and medical conditions encountered in sports. The team physician also must actively integrate medical expertise with other healthcare providers, including medical specialists, athletic trainers, and allied health professionals. The team physician must ultimately assume responsibility within the team structure for making medical decisions that affect the athlete's safe participation.

II. Qualifications of a Team Physician

The primary concern of the team physician is to provide the best medical care for athletes at all levels of participation. To this end, the following qualifications are necessary for all team physicians:

• Have an MD or DO in good standing, with an unrestricted license to practice medicine
• Possess a fundamental knowledge of emergency care regarding sporting events
• Be trained in CPR
• Have a working knowledge of trauma, musculoskeletal injuries, and medical conditions affecting the athlete

In addition, it is desirable for team physicians to have clinical training/experience and administrative skills in some or all of the following:

• Specialty Board certification
• Continuing medical education in sports medicine
• Formal training in sports medicine (fellowship training, board recognized subspecialty in sports medicine [formerly known as a certificate of added qualification in sports medicine])
• Additional training in sports medicine
• Fifty percent or more of practice involving sports medicine
• Membership and participation in a sports medicine society
• Involvement in teaching, research and publications relating to sports medicine
• Training in advanced cardiac life support
• Knowledge of medical/legal, disability, and workers' compensation issues
• Media skills training

III. Duties of a Team Physician

The team physician must be willing to commit the necessary time and effort to provide care to the athlete and team. In addition, the team physician must develop and maintain a current, appropriate knowledge base of the sport(s) for which he/she is accepting responsibility. The duties for which the team physician has ultimate responsibility include the following:

Medical management of the athlete

• Coordinate pre-participation screening, examination, and evaluation
• Manage injuries on the field
• Provide for medical management of injury and illness
• Coordinate rehabilitation and return to participation
• Provide for proper preparation for safe return to participation after an illness or injury
• Integrate medical expertise with other health care providers, including medical specialists, athletic trainers and allied health professionals
• Provide for appropriate education and counseling regarding:
• Nutrition
• Strength and conditioning
• Ergogenic aids
• Substance abuse
• Other medical problems that could affect the athlete
• Provide for proper documentation and medical record keeping

Administrative and logistical duties

• Establish and define the relationships of all involved parties
• Educate athletes, parents, administrators, coaches, and other necessary parties of concerns regarding the athletes
• Develop a chain of command
• Plan and train for emergencies during competition and practice
• Address equipment and supply issues
• Provide for proper event coverage
• Assess environmental concerns and playing conditions

Education of a Team Physician

Ongoing education pertinent to the team physician is essential. Currently, there are several state, regional and national stand-alone courses for team physician education. There are also many other resources available. Information regarding team physician specific educational opportunities can be obtained from the following organizations:

• American Academy of Family Physicians (AAFP) 11400 Tomahawk Creek Parkway Leawood, KS 66211-2672 913/906-6000 www.aafp.org
• American Academy of Orthopaedic Surgeons (AAOS) 6300 North River Road Rosemont, IL 60018 847/823-7186 www.aaos.org
• American College of Sports Medicine (ACSM) 401 W. Michigan Street Indianapolis, IN 46202-3233 317/637-9200 www.acsm.org
• American Medical Society for Sports Medicine (AMSSM) 11639 Earnshaw Overland Park, KS 66210 913/327-1415 www.amssm.org
• American Orthopaedic Society for Sports Medicine (AOSSM) 6300 North River Road, #500 Rosemont, IL 60018 847/292-4900 www.sportsmed.org
• American Osteopathic Academy of Sports Medicine (AOASM) 7600 Terrace Avenue, Suite 203 Middleton, WI 53562 608/831-4400 www.aoasm.org

Team physician education is also available from other sources such as: sport-specific (e.g., National Football League Team Physician's Society) or level-specific (e.g., United States Olympic Committee) meetings; National Governing Bodies' (NGB) meetings; state and/or county medical societies meetings; professional journals; and other relevant electronic media (Web sites, CD-ROMs).

Conclusion

This Consensus Statement establishes a definition of the team physician, and outlines a team physician's qualifications, duties and responsibilities. It also contains strategies for the continuing education of team physicians. Ultimately, this statement provides guidelines that best serve the health care needs of athletes and teams.

Expert Panel

John A. Bergfeld, MD; Cleveland, Ohio

Joel Boyd, MD; Edina, Minnesota

William G. Clancy, Jr., MD; Birmingham, Alabama

H. Royer Collins, MD; Phoenix, Arizona

Brian C. Halpern, MD; Marlboro, New Jersey

Stanley A. Herring, MD; Seattle, Washington

Rebecca Jaffe, MD; Chadds Ford, Pennsylvania

W. Ben Kibler, MD; Lexington, Kentucky

E. Lee Rice, DO; San Diego, California

David C. Thorson, MD; White Bear Lake, Minnesota

This guideline for identification and planning for medical services should not be construed as including all proper methods of care and planning or excluding other acceptable methods of care and planning reasonably directed to obtain the same result. The ultimate judgment regarding specific measures to be taken by a physician or the sidelines of an athletic event must be made in light of all circumstances which might occur and the needs and resources particular to the locality or institution.

Physicians and others are encouraged to reproduce this Information Statement for widespread distribution. Permission to reprint the Information Statement is hereby granted by AAFP, AAOS, ACSM, AMSSM and AOSSM, provided that the Information Statement is reprinted in its entirety including citations and that such reprints contain a notice stating:

“999 American Academy of Family Physicians, American Academy of Orthopaedic Surgeons, American College of Sports Medicine, American Medical Society for Sports Medicine and American Orthopaedic Society of Sports Medicine. Reprinted with permission."

If you wish to use the Information Statement in any other fashion, written permission must be obtained from the AAFP, AAOS, ACSM, AMSSM, and AOSSM.

Adopted October 1999 by the Board of Directors of the American Academy of Orthopaedic Surgeons. Reviewed December 2007.

Information Statement 1021

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