As more and more allegations of sexual harassment and abuse become known,
it's time for sports physicians to take stock of the ethical standards
in our profession.
Nothing matters more in our work than our moral authority. We seem to live
in a valueless society, one where accruing wealth is the major goal, without
any higher purpose, mission, or vision. In sports, this turpitude takes
many forms, including steroid abuse, cheating, and falsifying birth certificates
for youth sports. Sports physicians must provide both reason and leadership
in this arena.
Source: Stephen B. Morton/AP
Too many in our profession fall short of that calling. I'm thinking
of those physicians who supplied performance-enhancing drugs to such star
athletes as Mark McGwire and Lance Armstrong.
I'm also thinking of
Larry Nassar, MD, who has confessed to molesting young gymnasts. Some of the victims have complained that the sports establishment around
Dr Nassar, including some involved with the Olympics, covered up for him,
pressuring them to stay silent.
Challenges That Sports Physicians Face
It's hard being a doctor in the current environment of struggle and
conflict. You have to be informed and nimble and work harder as reimbursements
get lower. And because of the public attention focused on our patients,
sports medicine specialists are under particular pressure.
All doctors are bound by the
Physician Payments Sunshine Act requiring disclosure of relationships to pharmaceutical and medical implant
companies. But for sports physicians, these conflicts are compounded by
marketing arrangements from our teams, schools, and health centers.
All doctors feel pressure to treat patients even when we have no good treatment
to offer. Sports physicians face the added pressure to help our patients'
teams win at all costs and to violate our patients' privacy when we
get calls from the news media.
All doctors face temptations because of the trust our patients put in us.
Sports physicians must also grapple with distorted perspectives because
of the importance attached to our patients, which can give us the impression
that the rules don't apply to us.
As the great UCLA basketball coach and my omnipresent mentor John Wooden
said, "It is best not to drink too deeply from a cup full of fame.
It can be intoxicating, and intoxicated people often do foolish things."[1,2]
Consequences of Illegal and Unethical Actions
You don't have to look far in the sporting world to find examples of
the fall from grace.
Mark McGwire will be remembered as much for doping as for hitting home runs.
Source: Amy Sancetta/AP
Joe Paterno's record as one of the greatest coaches of all time is
forever stained by
allegations of failing to follow up on child-molestation charges against
assistant coach Jerry Sandusky.
I truly believe that character is the true foundation for all of success.
You may possess money, position, and power, but without good character
you cannot be successful.
Personal Mission Statement and Moral Course of Action
Where can we find guidance around these moral pitfalls? Our profession
has one of the oldest codes of conduct,
dating back 2500 years to the Hippocratic Oath, which calls on physicians to maintain their patients' confidentiality
and avoid "any voluntary act of impropriety or corruption, including
the seduction of women or men."
But I also believe that every physician should write a personal mission
statement. Here's mine:
- I will accept that I am what I eat, drink, think, and do.
- I will live life optimistically, motivating the people around me.
- I will discover adventure and passion in all things I do.
- I will cultivate good relationships with my patients and a home team with
my family.
- I will put character and values ahead of everything else.
In my own career, I've usually found that the biggest challenge is
not finding the moral course of action. It is remembering that I must
never deviate from that course. I always remind myself of the great former
Olympic and University of Portland coach Clive Charles, who said, "Do
the right thing a hundred percent of the time."
When I'm filing my taxes, I say to my accountant, "Find the line
and go two steps back." I use the same principle when I decide on
canceling a surgical patient who has a cold. I don't want to look
back on a decision to operate and say, "My patient has an infection,
and I could have avoided it."
You're not being a good doctor if you give 16-year-olds steroids because
you think they will like you more. You're not being a good doctor
if you give a stem cell injection when you know there is no true evidence
for the benefit. These breaches exploit the gap between patient hope and
knowledge while jeopardizing legitimacy.
To succeed, we have to remember that our goal is not only to heal but also
to inspire and educate our patients and our community and to motivate
them to be the best they can be. Achieving that goal doesn't require
steroids, it doesn't require cheating, and it doesn't require
mistreatment of people for your own interests, whether they are sexual
or financial.
It requires the moral courage, strength, and wisdom to deliver the right
and best tools to our patients so that they can achieve their own goals.
It requires the integrity to match what we say and what we do within our
organization and to convey these messages to our patients and the outside
world. And it requires nurturing our patients by understanding that they
have sought us out because the issues in and of themselves are challenging.
That will make all the difference.
Follow Medscape Orthopedics on Twitter for more orthopedics and sports
medicine news:
@MedscapeOrtho
References
-
Wooden J.
Wooden: A Lifetime of Observations and Reflections On and Off the Court. New York, NY: McGraw-Hill Education; 1997.
-
Mandelbaum BR.
The Win Within: Capturing Your Victorious Spirit. Austin, TX: Greenleaf Book Group Press; 2014.
Medscape Orthopedics © 2018 WebMD, LLC
Any views expressed above are the author's own and do not necessarily
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Cite this article: Sports Physicians Face Ethics Challenges -
Medscape - Jan 05, 2018.