NFL player health: The role of club doctors

November 21, 2016

How can we ensure that National Football League players receive excellent health care they can trust from providers who are as free from conflicts of interest as realistically possible? The lead article in a new Hastings Center Report special report concludes that conflicts of interest are inherent to the structure of the relationship between players and club doctors and that these conflicts pose a threat to players' health. The article proposes structural changes to reduce these problems.

Doctors and other medical providers who treat football players are hired by the clubs. "The current structure forces club doctors to have obligations to two parties -- the club and the player -- and to make difficult judgments about when one party's interests must yield to another's," states the lead article, "A Proposal to Address NFL Club Doctors' Conflicts of Interest and to Promote Player Trust."

It proposes to "resolve the problem of dual loyalty by largely severing the club doctor's ties with the club and refashioning that role into one of singular loyalty to the player-patient." Specifically, club physicians would be replaced by two sets of medical professionals: the players' medical staff, with exclusive loyalty to the player, and the club evaluation doctor, with exclusive loyalty to the club.

Existing ethical codes and legal requirements are not adequate to ensure that players receive health care that is trustworthy and as free of conflicts of interest as is realistically possible, the article says, making structural change necessary. "This structure--which is flawed even in the absence of ethical lapses by any individual club doctor--may substantially contribute to player health concerns," it concludes.

The recommendations come from The Football Players Health Study at Harvard University, which is working on prevention, diagnostics, and treatment strategies for the most common and severe conditions affecting professional football players and is funded pursuant to an agreement between Harvard and the NFL Players Association. The authors are I. Glenn Cohen, a Hastings Center fellow who is a professor at Harvard Law School, the faculty director of the Petrie-Flom Center for Health Law Policy, Biotechnology, and Bioethics at Harvard Law School, and a co-lead of the Law and Ethics Initiative of The Football Players Health Study; Holly Fernandez Lynch, the executive director of the Petrie-Flom Center and a co-lead of the Law and Ethics Initiative of The Football Players Health Study; and Christopher R. Deubert, the senior law and ethics associate for the Law and Ethics Initiative of The Football Players Health Study.

The lead article's recommendations are followed by seven commentaries and a response by the authors of the lead article. Among the commentaries:
For more information and a list of authors, see the table of contents and abstracts.

The Hastings Center

Related Health Care Articles from Brightsurf:

Study evaluates new World Health Organization Labor Care Guide for maternity care providers
The World Health Organization developed the new Labor Care Guide to support clinicians in providing good quality, women-centered care during labor and childbirth.

Six ways primary care "medical homes" are lowering health care spending
New analysis of 394 U.S. primary care practices identifies the aspects of care delivery that are associated with lower health care spending and lower utilization of emergency care and hospital admissions.

Modifiable health risks linked to more than $730 billion in US health care costs
Modifiable health risks, such as obesity, high blood pressure, and smoking, were linked to over $730 billion in health care spending in the US in 2016, according to a study published in The Lancet Public Health.

Spending on primary care vs. other US health care expenditures
National health care survey data were used to assess the amount of money spent on primary care relative to other areas of health care spending in the US from 2002 to 2016.

MU Health Care neurologist publishes guidance related to COVID-19 and stroke care
A University of Missouri Health Care neurologist has published more than 40 new recommendations for evaluating and treating stroke patients based on international research examining the link between stroke and novel coronavirus (COVID-19).

Large federal program aimed at providing better health care underfunds primary care
Despite a mandate to help patients make better-informed health care decisions, a ten-year research program established under the Affordable Care Act has funded a relatively small number of studies that examine primary care, the setting where the majority of patients in the US receive treatment.

International medical graduates care for Medicare patients with greater health care needs
A study by a Massachusetts General Hospital research team indicates that internal medicine physicians who are graduates of medical schools outside the US care for Medicare patients with more complex medical needs than those cared for by graduates of American medical schools.

The Lancet Global Health: Improved access to care not sufficient to improve health, as epidemic of poor quality care revealed
Of the 8.6 million deaths from conditions treatable by health care, poor-quality care is responsible for an estimated 5 million deaths per year -- more than deaths due to insufficient access to care (3.6 million) .

Under Affordable Care Act, Americans have had more preventive care for heart health
By reducing out-of-pocket costs for preventive treatment, the Affordable Care Act appears to have encouraged more people to have health screenings related to their cardiovascular health.

High-deductible health care plans curb both cost and usage, including preventive care
A team of researchers based at IUPUI has conducted the first systematic review of studies examining the relationship between high-deductible health care plans and the use of health care services.

Read More: Health Care News and Health Care Current Events is a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to