Rx for a Medical Dilemma

The team doctorswho once paced the NFL sidelines in coats and ties that screamed Marcus Welby,M.D., have been replaced over the last decade by physicians attired in teamapparel that makes them indistinguishable from equipment managers. As oneplayer recalls, his first thought last season in a moment ofvulnerability--injured on the field, with medical staffers rushing to him--was,"Here come the pod people."

Whose side arethey on? he wondered. The docs tend to the player but answer to ownership. Someare on the team payroll, others have entered into promotional deals for theirservices. "If we were dressed different from the team," Ravens teamdoctor Andrew Tucker says, "I wonder if it would help a player believe wewere giving him an independent, objective medical opinion."

As difficult asteam doctors are to spot, they are even harder to hear. Their diagnoses arefiltered to the public through coaches, whose medical expertise consists ofextracting the funny bone with tweezers in the board game Operation and who useinjury updates as strategy: Don't let 'em know if a star is hurt or healthy.Why allow coaches the power to disseminate medical information when they oftendistort it for game-day purposes? Their half-truths only perpetuate a cultureof dishonesty that encourages players to believe it's O.K. to lie aboutinjuries, to take the field when they may not be ready or able. Theirwink-winks into the camera only undermine the doctor's credibility when theinjury turns out to be something other than described.

Just look at howthis pervasive sense of distrust and subterfuge played out with three teamslast week. (No surprise that they're coached by the scheming Brotherhood ofHoodies--the Patriots' Bill Belichick and his disciples, the Browns' RomeoCrennel and the Jets' Eric Mangini.)

•Who knew that TomBrady had required multiple follow-up operations on his injured left kneebecause of infection? Or that New England's front office was irked because hedidn't use the surgeon recommended by the team? Or that Brady's knee might haveto undergo another reconstruction, which could cause him to miss next season aswell?

•Tight end KellenWinslow spoke out about Cleveland's cover-up of his staph infection--the sixthone experienced by a Browns player since 2005--only to be suspended for onegame by the team for remarks disparaging to the organization. Cleveland laterrescinded the punishment because, according to The Plain Dealer, the unionobtained text messages proving that the team had indeed told Winslow to zipit.

•Jets receiverLaveranues Coles, surrounded by reporters inquiring about his latestconcussion--his third since December '06--said any comments he made about hisinjury would be considered "detrimental to the team" and added,"Unless you want to fork over some cash, don't ask me no morequestions."

In setting up aconcussion hotline last year, league officials basically told players towhisper if they felt they were being forced to play with a head injury. Theymockingly called it 1-800-YOU-R-CUT. (The confidential phone line wouldn't havecaller I.D., would it?) This player paranoia is left for the team physician toheal. "We are open and honest with them," says Panthers physician PatConnor. "But as they know, there is also an expectation of transparency [inmy dealings] with the team."

Confidentialitycan get tricky. Football-related issues are transmitted to the team, but whatabout more personal matters? "This is where that unique situation of dualresponsibility comes in," Tucker says. "If a player's medicalissue--like depression--gets to the point where performance is affected, then Ihave the responsibility to certain people in the club. . . . Now, sometimesplayers will choose to share that information with other people."

So some playersseek second opinions and alternative therapies--such as acupuncture or bannedHGH--to expedite healing, possibly keeping the team doctor in the dark. Asformer Raiders physician Robert Huizenga notes, "I was surprised when Ileft the Raiders at how many [players] said, 'Now that you're not on the team,I really need your help.' How much was hidden from me?"

It's time for anew NFL health-care system: For players to feel more trusting, doctors shouldbe under the umbrella of a league-union cooperative instead of retained byindividual owners. That's a big change, but until it takes place, baby stepscould restore doctors' authority. Let them lose the logos and be seen asphysicians on the field. And let them be the voice of weekly injury reports,without a coach to downgrade a sprain to a tweak. That way the real healing--ofthe players' faith--can begin.

TALK BACK If you have a comment on medical care in theNFL, send it to SI.com/pointafter.

Diagnoses by team doctors are filtered through NFLcoaches, whose medical expertise consists of extracting the funny bone in theboard game Operation.

ILLUSTRATION

ILLUSTRATION BY KEITH WITMER