Page 31 - Hoag Orthopedic Institute 2018 Outcomes Report
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 The intersection between head trauma and mental health has also been increasingly relevant to the medical team physician. As more is understood of the potential impacts of head trauma on mental health, the medical team has become more engaged in matters that center on this interface.
Focus on hydration and micronutrient health has also grown over the past few years, as more athletes are gaining interest in optimizing hydration as well as optimization of particular micronutrients (such as vitamin B12 and vitamin D) that may have roles in affecting performance and health. As the medical physician for a team, a significant aspect of my role also involves
not only helping the players, but also coaches, administration, families and ownership navigate their health care systems. With the changing landscape of health care, this has been an increasingly challenging aspect of the team physician’s role. With complex payer systems across a wide health network, the team physician becomes a critical navigator in that landscape.
Can you describe what happens on game day from your perspective?
For games played at home, the team physicians will arrive at the stadium a few hours prior to kick-off. Players will arrive at variable times depending on their routines, while the team physicians arrive early to begin preparing with the athletic training staff. The various members
of the medical team will divide responsibilities so as to ensure a consistent and comprehensive
preparatory process for the players. The athletic training staff will help tape up players and also provide treatments to those who need particular modalities prior to starting the game. The team chiropractors will also be available on site to help provide last minute treatments to those in need of it. The orthopedic surgeons will help address the musculoskeletal complaints of any players and provide recommendations as well
as treatment for players prior to the start of the game. The medical team physicians will provide support for any general medical issues that need to be addressed.
The most common game-day issues on the medical side would involve hydration support for those in need of IV fluids or medications for those with medical conditions. An hour before kick
off, a “medical time-out” will be held to provide
an opportunity for all medical staff to review protocol. The NFL mandates such a meeting, and those involved include the head team physicians of the home and visiting teams, the head athletic training staff, neurologic consultants, airway management physicians, EMS, and the referees. The players will eventually make it on to the
field for warm-up drills and to prepare for the game. During this time, the team physicians will also come onto the field to be available for any issues that may arise but also to make sure the preparations for the game have been made. Once the game begins, the team physicians will typically stand at designated positions to watch the plays from the sideline.

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