Team Doctors Jump In After Professional Athletes Benched

Laird Harrison

March 26, 2020

Editor's note: Find the latest COVID-19 news and guidance in Medscape's Coronavirus Resource Center.

COVID-19 has had an effect on professional sports around the world that rivals that of World War II, and the seasons of all major sports in the United States ground to a halt after some players in the National Basketball Association tested positive for the virus.

First came hand sanitizers at doorways. Then the ban on journalists in locker rooms. Then games with no spectators. And then, there were no games, no practices, no gatherings of athletes at all.

The seasons could be on hiatus for much longer than originally thought. For team doctors, the COVID-19 pandemic has imposed constraints unlike any they have seen before.

The shutdown applied not only to professional sports, but also to college, high-school, and recreational sports throughout much of the country. The White House has advised that people avoid gatherings of 10 people or more, and many states have gone much further. Even individual sports are affected.

James Bradley

"One patient could touch the lives of 70 people," or more, said James Bradley, MD, from the University of Pittsburgh School of Medicine, who works with the Pittsburgh Steelers in the National Football League and is currently president of the American Orthopaedic Society for Sports Medicine (AOSSM)

At his institution, "all elective surgery has been cancelled," he told Medscape Medical News.

"Ski resorts are closed, there's no football, soccer, hockey, or any of that," said Bert Mandelbaum, MD, a team physician for the Los Angeles Galaxy Major League Soccer team and for the US men's national soccer team.

Patients are not showing up with the usual sports-related broken bones and torn tendons at clinics like Mandelbaum's Santa Monica Orthopaedic & Sports Medicine Group, and he and others are rescheduling nonemergency surgeries to free up resources at hospitals and reduce the risk of COVID-19 exposure for patients and clinicians.

Bert Mandelbaum

"When you're doing elective surgery, you have a lot of personnel and equipment focused on it, including ventilators," Mandelbaum said. "And you're operating in the environment; you're creating stress in people who may be infected but not symptomatic."

Patients Wait in Cars

Patients who come for urgent surgery must wait in their cars to avoid crowding in waiting rooms at the University of Pittsburgh, Bradley reported. A team has been put in place to make sure surgeons follow the new protocol, and those who schedule unnecessary surgeries can expect a phone call challenging them.

If athletes don't live in the Pittsburgh area, Bradley said he arranges to have them seen where they are so they don't have to get on airplanes.

But more and more, he has been using electronic communication to work with athletes. Players have been sending Bradley videos that show their throwing or running motion so he can diagnose problems.

The Trump administration has temporarily expanded telehealth benefits to allow more Medicare patients to receive virtual care without having to visit a healthcare center or physician's office, as reported by Medscape Medical News.

And the US Department of Health and Human Services is temporarily allowing clinicians to communicate with their patients through commercially available video conferencing and texting programs, not just technology developed specifically to protect patient confidentiality.

"People are allowed to use telemedicine a lot more freely than they have in the past," said Claudette Lajam, MD, from NYU Langone Health in New York City. Although Langone already has an encrypted system, "I know a lot of my colleagues in private practice are trying to set something up."

The administration is also working to open up regulations to allow physicians to work across state lines, as reported by Medscape Medical News.

These changes will make it easier for doctors to see their patient by video conferencing, said Lajam. But the cancellation of the American Academy of Orthopaedic Surgeons 2020 Annual Meeting is a frustration for many orthopedic surgeons.

"It's sad that we won't be able to meet in person," she said. She is particularly disappointed that the academy's first female president, Kristy Weber, MD, from Penn Medicine in Philadelphia, will not get an opportunity to preside over the meeting.

"But all of the academic content for that meeting is done," Lajam explained. "People have written their papers and posters. Once we have finished addressing the immediate concerns of the crisis, we're planning to offer virtual meeting content to our members."

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