The Doctor Isn't Always Right

     Doctors are experts. The level, field, and breath of expertise varies from doctor to doctor. Out of respect for their level of education, their practice and their experience in the field, the healthiest stance is to say that every doctor is a medical authority on something.

     

     This week, I met with an optometrist who was furious that sports organizations are allowing kids to participate in sports wearing eye wear that is not explicitly recommended by her professional organization. I understand her point. She and her colleagues are eye care experts.  Chances are, the local high school field hockey coach isn’t a medical expert of any kind. But, as a coach and league administrator, I don’t care what her group recommends and there’s little to no chance that I’d support a blanket rule requiring a specific type of eye wear.

     

     Sports organizations don’t jump to make changes with every medical recommendation they here. But why? These people are medical experts.

     

     One factor is money. Most medical visits and recommended equipment cost money. Some expenses are cost-prohibitive for many families. Athletics rule-makers tend to shy away from rules that add an expense to the cost of participation. It’s not that the recommendation isn’t good. It’s that the cost of the recommendation often eliminates participants.

     

     But more simply than the money answer is that fact that if organization’s followed every recommendation made by every doctor, nobody would ever play sports again.

     Think about how many fields of medicine are out there. In addition to the optometrist’s recommendations, I’ve heard all of the following recommendations from medical experts in the past year.

-               - Nobody who has ever suffered a concussion should ever play contact sports again.

-               - Those who are suffering from depression should not participate in sports.

-               - If you’ve had an ear, nose and/or throat infection in the past month, you should not play sports.

-               - Athletes who have not been tested for sickle cell trait should not participate in athletics.

-               - Kids with orthodontic braces and/or appliances should limit physical contact.

     These are just a few of them. I’m sure athletic trainers and team physicians hear way more than the coach ever hears.

     I’ve made no effort to learn whether these recommendations are congruent with the professional organization of each medical field’s official stance. But it coaches followed just these recommendations across the board, without checking in with any other medical expert, who’s left to participate?

     I can imagine the flier in the hallway of the local middle school. “Basketball tryouts this Friday. Everyone welcome…Unless you wear glasses, go to the orthodontist, have a runny nose, have ever been hit in the head, have any form of anxiety, and/or are unaware of your sickle cell trait.”

I know this. I coach a collegiate team of 28 student-athletes. If I had a match today and used only the players who pass through all of these criterion, I’d have 2 players…I think. I’m sure if I checked in with a chiropractor, an OB/GYN, a podiatrist and an orthopedic expert, they could find a way to rule our everyone on my team.

     As a rules committee member, I’ve learned that valuing the opinion of one set of doctors over another can be a slippery slope. Unless a committee believes there’s an inherent an avoidable risk for the sport’s participants that can be easily avoided or corrected with a rule change that will be easily implemented, it’s unlikely that a rule with change based on a medical expert’s recommendation. And, while it’s not true of all medical recommendations, expert’s opinion’s change with more time and more research. 

     Remember, it wasn’t more than a century ago that doctors were treating drowsiness and body aches with cocaine. It wasn’t a half-century ago that we were rubbing whisky on the gums of teething babies. It was just a few years ago that equipment manufacturers were producing helmets based on recommendations to avoid skull fractures with no regard for concussions.

     So, what should we do as parents of athletes? Find a physician that you trust that was active as a kid. Even better if they're still active and add a double bonus if the children in their family are active. Take their recommendations into consideration, and do what you believe is best for your child. Rules or no rules, that’s a parent’s job. It’s no different for sports parents.

     You won't always be right. But if we follow the recommendations and warnings of every doctor we meet, our kids might never play sports again.