Articles

John B. McGinty, MD, Orthopedics Today, December 2001

Physicians who buy affiliations to major sports teams overstep ethical boundaries of quality medicine.

When I went into the practice of orthopedics, the idea of a physician advertising to promote his or her practice was considered unethical by most people. Today, advertising by physicians is commonplace in local newspapers, magazines and in the yellow pages. It seems that the marketing aspects of the business have taken over the ethical considerations.

One has to wonder if this change is a plus or a minus to the quality of care and to the viability of the patient-physician relationship. To this observer, advertising is bad enough but buying patients crosses the ethical boundaries of quality medical practice.

The term "team doctor" in the past used to create the image of not necessarily the best physician in the community but at least a person who had an open, trusting relationship with the team and was motivated to give quality care and was not motivated by financial gain. Now some medical groups and physicians are paying professional teams as much as $1.5 million a year for the prestige of affiliation.

Sold to highest bidder

The biggest problem is in major league baseball where 25 clubs have a health care sponsor and five have exclusive agreements. If there ever were a conflict of interest situation with the patient in the middle, this is it. It seems amazing that these clubs with their enormous payrolls would go out to the highest bidder for the care of their very expensive athletes. You would think that, as with any other consultant, they would seek and pay the very best to protect their precious investments. Whatever relatively small amount of money is saved is easily lost when the wrong decision or treatment is given to a multimillion-dollar athlete. Team physicians should be selected on the basis of their ability and experience in treating sports injuries, not on financial considerations.

Some major league teams are selling the exclusive right to be their official team physician. If players want an opinion from a second physician, even a former team physician, they must seek it at their own expense just like an individual in a medical plan who wishes to visit an out-of-network doctor. USA Today reported last month that the New York Mets in the off-season called for bids to be the official caregivers of the team. Just before spring training, the New York Hospital for Joint Disease bought the designation. The previous team physician, who refused to bid, was replaced. One hospital entrance displays a banner with the Mets logo that touts the official link to the team. The hospital's Web site home page displays the Mets logo and the association is advertised on Shea Stadium signs.

The San Francisco Giants have a 10-year, $15-million deal with Catholic Healthcare West, which pays for the connection with the ballclub and gets the rights to charge for services to players including those in the minor league system. Apparently the association with the Giants has brought additional business to the health care group, and the Giants are happy with their new revenue source. 

The players' union permits players to seek a second opinion from a list of two approved specialists per specialty. Major league baseball compiles the list in conjunction with the union.

Care could be compromised

We all know from our own experience that the quality of care is not ensured by the financial arrangement between the consumer and the provider. It is hard to believe that a professional sports organization would chance compromising the care of its players for relatively small financial gain. The physicians involved in these arrangements may consider themselves distanced from the deal because the direct receipt of cash is to their organizations and not to themselves. But those physicians are providing the services to the players and therefore selling themselves to get this "privilege" and can make use of their association with the team through advertising. 

It seems to me that considering this type of financial arrangement ethical is pure rationalization. Our goal is to provide care without the outside influences that must exist with this apparent conflict of interest. The professional athletic organizations should be buying the care from the best available sources. The physicians should not be paying for the privilege of providing this care.

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