Those who work for NFL teams spend an extraordinary amount of time dealing with medical issues on a daily basis. What are these issues? Well, here’s a start...
• Receiving updates from our doctors and trainers on the health of our players.
• More in-depth conversations with the trainers or doctors about a specific injury and his time frame for recovery.
• Working on injury settlements with agents, projecting out recovery time to find common ground.
• Dealing with workers’ compensation issues for former and yes, current players.
• Working on injury waivers for incoming players with pre-existing medical conditions.
• Working on injury disclosure information and assessing whether a player was truthful and forthcoming in his intake.
• Monitoring concussion and brain injury recovery and protocols.
• Working with team and league insurance carriers on coverage and exposure matters.
• Working with other teams and injury inquiries about players coming to or from our team.
• Dealing with the league on best practices regarding certain injury matters.
• Dealing with agents on second opinions for their players or outside surgeries for their players, as permitted by the CBA.
• Defending injury grievances brought by released players alleging they were still injured upon release.
• Dealing with termination pay issues for released vested veterans.
• Dealing with trainers on players not following treatment plans or insubordination to training or conditioning staff.
• Dealing with players’ personal trainers, chiropractors, massage therapists and other “gurus” about training and treatment.
• Answering league inquires on injury designations on practice reports.
• Answering league inquiries on injury designations of “minor” or “major” for Reserve/Injured reporting.
And that is just a partial list.
The relationship between NFL players and team medical personnel varies from team to team. However, an undeniable trend, fueled by agents and the NFLPA, is that the default setting for players is now distrust towards team medical personnel.
The narrative about team medical staff has become that they are doing what is best for the team, not what is best for the player. Is this true? Well, it is hard to make any blanket statement but I will say that what I saw from Packers team doctor Pat McKenzie was very different than that narrative. Pat not only put the player first but also frustrated both players and team personnel with conservative recovery times for injuries, as has been noted with Aaron Rodgers’s injuries over the years.
I do realize, however, that my Packers’ experience may even be outside the norm. And a couple of recent cases are troubling.
Disputes in public view
The contentious and public disputes between Trent Williams and Washington and Kelechi Osemele and the Jets illustrate how delicate and potentially adversarial these medical situations can become. And I have no doubt there are more out there that have not become public as these have.
Williams spoke candidly to reporters about a cancerous growth on his skull that was, he alleges, misdiagnosed and mistreated by the Redskins. The team responded by agreeing to submit to a joint review by the NFL and NFLPA. Williams, however, instructed the NFLPA to stand down, not wanting to relive an experience about which he said, “I almost lost my life.” The team then took an adverse position, placing Williams in the roster category equivalent of NFL purgatory, NFI—non-football illness—and opting to not pay his remaining 2019 salary.
Doctors consulted by Osemele and his agents advised him to have shoulder surgery. Although the Jets disagreed, Osemele chose to have the surgery anyway, and the Jets summarily released him the next day.
In both cases of course, there will be lawyers. In Williams’ case, Washington reportedly is even raising the stakes, claiming that Williams’ contract will toll — due to the NFI status — giving the team contractual rights for another year. Osemele will pursue a grievance for salary while also weighing action against the Jets’ medical staff for violations of state medical board regulations. The relationship between the players and the teams is beyond repair.
Team defenses and concerns
Having worn the hat for a decade in Green Bay, I try to put myself in the position of the teams in these disputes. They are correctly saying as little as possible, cognizant how sensitive the situations are, but they likely believe that the narrative that has been framed by the player is not the entire story. From experience, I know that these medical situations are never one-sided; there is always a player side to the story, a team side, and the truth lying somewhere in between.
The larger problem for the teams is the bigger picture. Whatever a team does with one player—good or bad—becomes an example of how they treat all players. Teammates and their families have watched the treatment of Williams and Osemele, two veterans with, we assume, respect in the locker room. And, I believe, this is why the Jets released Osemele and Washington removed Williams from the roster, wanting the disputes to play out outside the locker rooms rather than fester inside them. In any case, these are not good looks for the teams, no matter their side of the story.
The NFL CBA allows players to access outside medical opinions and surgeries, and mandates that players spend several months away from team facilities in the offseason. Thus, players are working with personal trainers, therapists and even doctors for a good part of the year. And these practitioners often have differing and varying opinions on optimal care for their bodies and any injuries suffered.
The issue created by receiving outside care is more pronounced for star players with financial means to support personal care. For example, do we really think a player like Tom Brady is going to listen to Patriots’ training and medical staff more than he listens to his full-time trainer (and business partner)? There are dozens of similar situations around the league.
How to improve?
What, then, can be done to improve relations between players and teams regarding medical issues? In a sport with 70 players per team and a high injury rate, there are going to be disputes on care, treatment, surgery, rehabilitation, etc. no matter how positive the relationship is between the team and players.
Perhaps one answer could be some extension of the joint review by the NFLPA and NFL mentioned above with the Williams case. Perhaps there could be a medical review board that could weigh in on player-team medical disputes in an expert and professional manner. The board could be comprised of one doctor from the league side, one doctor from the player side, and 1-3 doctors approved by both sides, along with a list of jointly approved consulting physicians on specialized injuries. This would not solve all disputes but could, at a minimum, be an expert sounding board with well-intentioned professionals looking at disputed cases. This is one idea; perhaps there can be more flowing from that.
Medical disputes between players and teams consume an extraordinary amount of time from team personnel and agents, with even more to be consumed going forward.
There will be doctors. And lawyers.
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