Football teams, brain injuries, and independent doctors

From The New York Times, reporting on Congressional hearings regarding head-injuries by NFL players:

Roger Goodell, the commissioner of the National Football League, defended the league’s response to the issue of concussions and the care of retired players before the House Judiciary Committee on Wednesday in a hearing called to discuss the long-term effects of head injuries in football.

Goodell joined a chorus of voices discussing the issue at the daylong hearing. While DeMaurice Smith, executive director of the N.F.L. players association, called for more independent study of head injuries and promised that players’ safety would not be a bargaining issue with the league, a former N.F.L. team executive, Gay Culverhouse, made an impassioned plea for doctors independent of the teams to oversee care of the players.

It was Goodell, however, who was the focus of interest for Representative John Conyers Jr., Democrat of Michigan, the committee’s chairman. Conyers pressed Goodell to address the link between concussions sustained while playing football and long-term brain deterioration. The N.F.L., mostly through the comments of Dr. Ira Casson, the head of the league’s concussion committee, has frequently played down studies that have made such a link and cited the need for further study.

Asked by Conyers whether he believed there was a link between concussions and dementia, Goodell replied, “The answer is, medical experts would know better than I do.” He went on to say that he encouraged the debate and that the league was adjusting rules and standards of care to make the game safer even before the answer is found. . . .

“In a matter of public health, I do not think it’s acceptable for the league and the players association to hide behind the collective bargaining agreement,” Conyers said. “These are life-and-death issues that go to the heart of our most popular sport.”. . .

In his opening remarks, Smith, the director of the players union, did not directly take issue with the N.F.L.’s approach, although in the statement he filed with the committee he assailed the N.F.L. for “denigrating, suppressing and ignoring” research that has linked football concussions to long-term cognitive degeneration. He did, however, declare that medical issues should not be subject to negotiation in the collective bargaining agreement.

“The players of the N.F.L. will not bargain for medical care,” he said. “We will not bargain for safety. We will continue to bargain with the league, but medical care is not a bargaining issue.” . . .

Dr. Robert Cantu, a researcher from Boston University’s School of Medicine, said he believed there was “ongoing and convincing evidence” of a link between sports concussions and long-term illness. Culverhouse, former president of the Tampa Bay Buccaneers and daughter of the franchise’s original owner, made the most emotional plea in her opening statement, choosing to focus on the status of team doctors. She called for independent doctors to work at games, caring for players on both sidelines.

“What this committee has to understand is, the team doctor is hired by the coach and paid by the front office,” Culverhouse said. “This team doctor is not an advocate for the players. That doctor’s role is to get those players back on the field. I have seen a wall of players surround a player as he has his knee injected so he can get back on the field.

“The players get to a point where they refuse to tell the team doctor they have suffered a concussion. They do not self-report because they know there is a backup player on the bench ready to take their position. The team doctor dresses as a coach on the sideline and he acts in many ways as a coach on the sideline. If a player chooses independent medical counsel he is considered ‘not a team player.’ He becomes a pariah. We need to stop that.” . . .

I thought this was interesting, especially this latter part. Here’s my question: Why hasn’t the players’ union hired independent (at least independent of the NFL and individual franchise) doctors to be on hand? They could be paid with union dues and they could negotiate in their collective bargaining agreement that the NFL allow these doctors full access. It’d be a second-opinion for every player, and seems like a good check. I don’t mean to impugn doctors here, but when a normal employee gets an injury or illness he doesn’t (or shouldn’t, anyway) go solely to his company provided clinician to determine whether he can work or not.

I don’t know if it’d fix these other issues, but I’d like to see teams have more independent doctors, and the players union could furnish them. Colleges and high schools have fewer choices for this, unfortunately.

  • jack

    It’s a sad state of affairs when Truth no longer exists. Even the obvious — that repeated head trauma causes long term debilitating effects — becomes a he-said-she-said. Gee, it’s been accepted in boxers, but somehow concussions caused by NFL play is different? I had a lot of respect for Goodell up until this day. No more. I’m not so sure I like the new head of the players union either. Doesn’t sound much like a players’ advocate to me.

    I agree that the union hiring independent doctors is a good idea, but that still promotes the decay of Truth: MY doctor vs. YOUR doctor. Whatever happened to the notion that the doctor — ANY doctor — is primarily concerned with healing the patient?

  • OldSouth

    This may sound stupid, but has there been any research on helmet design in thirty years? I don’t know how much could really be done, but it seems like some more impact-resistant foam or something would help a lot.

  • cmartel

    TBI is nothing to laugh at. It’s serious and the long-term damage is debilitating. They ought to revisit helmet design and put a process in place to take players out of the game or out of several games until they’re sure the player is healed. They probably won’t, though, because: 1) Too much money involved. 2) Too many won’t believe it’s a real problem. 3) Too much money involved. Oh, yeah, I mentioned that already.

  • Ken

    “Why hasn’t the players’ union hired independent (at least independent of the NFL and individual franchise) doctors to be on hand? They could be paid with union dues….”

    The last clause there is the mischief. The NFLPA will want the owners to pick up the tab.

    I still wonder whether a return to leather helmets without facemasks would make a difference. It might not help interior linemen as much, although if the size of the shoulder pads were also scaled down it might help after all.

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