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SI: Do athletics still have too much power at Penn State?

At a time when health and safety issues have rattled football to its core, some members of the Penn State community can't fathom why one of the country's highest-profile and most-scrutinized college sports programs would do anything that might lessen athletic health care. Yet according to a special report in this week's Sports Illustrated, changes in the university's once-exemplary medical care are raising questions about the promises to rein in the athletic department and operate transparently. A number of former players and members of the Penn State football family told SI they are dismayed that Wayne Sebastianelli has been relieved of his duties as the longtime director of athletic medicine and orthopedic surgeon-head physician for the football team. It's part of an abrupt shift in the school's healthcare program for football -- a shift that will provide less on-site coverage. Instead of having an orthopedic surgeon who attends every practice, Penn State now employs a primary care physician in State College and an orthopedic consultant who commutes about two hours each way from Hershey, Pa., at least once a week.

The special report, written by senior writer David Epstein also found:

? Many members of the Penn State community are troubled by the circumstances surrounding the changes, which they attribute to David Joyner, the controversial new athletic director and also an orthopedic surgeon. A member of the board of trustees at the time of his appointment, Joyner had no experience in college athletic administration and has a contentious history with Sebastianelli. In the wake of the Jerry Sandusky scandal -- the longtime assistant football coach was found guilty of 45 counts of sexual abuse, and the school was fined $60 million by the NCAA and placed on five years' probation -- Penn State president Rodney Erickson acknowledged that "the nation's eyes are upon us," vowing to "ensure proper governance" of athletics and making a "commitment to transparency." The school even set up a website, Toward a More Open University. Erickson's appointing a university trustee as AD and the ouster of Sebastianelli -- which was done summarily, without reference to performance issues and based on the recommendation of Bill O'Brien, who had just finished his first year as football coach -- appear squarely at odds with those aims. "Here we are trying to change our image and approach administrative changes with clarity and openness," said Mac Evarts, former dean of Penn State's College of Medicine and a current professor of orthopedics at the university, "and we have another example of a decision being driven by athletics."

? According to current and former Penn State staff members, administrators, former players and longtime colleagues and friends of both Joyner and Sebastianelli, there is a deep history and a rivalry between Joyner and Sebastianelli. (Sebastianelli declined to comment about Joyner to SI. Through a university spokesman, Joyner said, "It's terribly unfortunate some want to make baseless accusations. ... The vast majority of Penn Staters want the focus to be on our dedicated student-athletes, as it should be.")

? Multiple former players and staff members told SI that they recalled Joyner and Sebastianelli having heated words several years ago over whether Joyner was trying to lure football players away from the university medical system.

? The sudden departure of the longtime orthopedic surgeon-head physician caused confusion among athletes, according to Penn State players and staff members. Several athletes say they were told that Sebastianelli had retired or resigned. Football players showed up at the hospital wondering if Sebastianelli could still remove their surgical sutures. Joyner began to approach Penn State doctors about filling Sebastianelli's position with the football team. According to sources familiar with that process, the Penn State medical community was stunned by the abrupt removal of Sebastianelli, and several doctors declined offers to succeed him.

? No official announcement regarding Sebastianelli was made when he was removed from the football program, and school personnel involved in internal discussions say that Penn State officials began to explore how they would justify, in the absence of performance issues, the removal of a longtime doctor with an endowed professorship. According to two people with knowledge of those discussions, Joyner's perceived dislike for Sebastianelli is widely enough known in State College that Penn State officials worked on talking points in case reporters asked whether Joyner was settling a personal score.

? In an interview with SI, O'Brien said that he made year-end recommendations for improvements to the football team that included changing medical personnel. (Joyner, he said, approved and implemented the changes and chose the new doctors.) O'Brien said that he is happy with the changes and that Scott Lynch, an orthopedic surgeon, was at most of the 15 spring practices that occurred over five weeks. "I believe that Dr. Lynch will be there just about every day in the fall," he said. A medical schedule Penn State gave to SI indicates that, during the week, Lynch will be expected to be present only on Wednesdays. Asked to address this apparent contradiction, O'Brien said, "At the end of the day, I believe in a primary care physician being here every day, that's something I believe in, and that's one of the recommendations I made." Penn State, though, already had a primary care physician -- Philip Bosha -- present at every practice. "That's what I believe in," O'Brien said, "which is what we have, and which is what we had." An athletic department staff member takes issue with the idea that coaches and ADs are making medical personnel decisions, saying, "How ironic is it that after everything that happened a year and a half ago, that the program is much more like an NFL program [in which doctors are picked by the team] than it ever was before."

? O'Brien hired Penn State alum Tim Bream, who worked with Joyner at the '92 Olympics, as athletic trainer in February 2012. Sources involved in health care for Penn State athletics who spoke with SI on the condition of anonymity say they saw Bream, who does not have a medical degree, engage in practices normally reserved for doctors, such as giving players anti-inflammatory drugs without a prescription and lancing a boil on a player's neck. University medical sources also said that Bream told physicians to stop talking with the parents of players and that doctors should not spend as much time with the team.

? According to trustee sources, Joyner's rationale for the change was cost savings. With decreased donations to athletics following the Sandusky scandal, a decline in football club-seat and suite renewals, and increased operating expenses, an athletic department that has perennially been one of the few in the country that is self-sustaining is approaching the red. During 2010-11 the athletic department reported a surplus of $14.8 million dollars. For '11-12, that plummeted to $863,000. "It's less good care," said Vincent Pellegrini, the former chair of the department of orthopedics at Penn State, "in exchange for saving a few bucks."

In response to SI's story, Penn State issued the following statement:

"To characterize the medical care Penn State provides our student-athletes as anything other than the highest quality is erroneous. Access to urgent and quality care for our athletes is no less than where it was at any point in the past 20 years. We provided Sports Illustrated with facts and data that demonstrate our commitment to our student athletes and how we compare to other peer institutions. Instead, the article sensationalizes in order to insinuate lower standards and largely ignores statements from the Dean of the College of Medicine.

Contrary to the reporter's assertions, Dr. Sebastianelli remains the doctor in charge of the University's entire medical program for intercollegiate athletics, including football. Further, there has been no change in the support provided by State College-based Penn State orthopedic surgeons, including Dr. Sebastianelli."

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