Rx For A Medical Dilemma

The team doctors who once paced the NFL sidelines in coats and ties that screamed Marcus Welby, M.D., have been replaced over the last decade by physicians attired in team apparel that makes them indistinguishable from equipment managers. As one player recalls, his first thought last season in a moment of vulnerability--injured on the field, with medical staffers rushing to him--was, "Here come the pod people."

Whose side are they on? he wondered. The docs tend to the player but answer to ownership. Some are on the team payroll, others have entered into promotional deals for their services. "If we were dressed different from the team," Ravens team doctor Andrew Tucker says, "I wonder if it would help a player believe we were giving him an independent, objective medical opinion."

As difficult as team doctors are to spot, they are even harder to hear. Their diagnoses are filtered to the public through coaches, whose medical expertise consists of extracting the funny bone with tweezers in the board game Operation and who use injury updates as strategy: Don't let 'em know if a star is hurt or healthy. Why allow coaches the power to disseminate medical information when they often distort it for game-day purposes? Their half-truths only perpetuate a culture of dishonesty that encourages players to believe it's O.K. to lie about injuries, to take the field when they may not be ready or able. Their wink-winks into the camera only undermine the doctor's credibility when the injury turns out to be something other than described.

Just look at how this pervasive sense of distrust and subterfuge played out with three teams last week. (No surprise that they're coached by the scheming Brotherhood of Hoodies--the Patriots' Bill Belichick and his disciples, the Browns' Romeo Crennel and the Jets' Eric Mangini.)

•Who knew that Tom Brady had required multiple follow-up operations on his injured left knee because of infection? Or that New England's front office was irked because he didn't use the surgeon recommended by the team? Or that Brady's knee might have to undergo another reconstruction, which could cause him to miss next season as well?

•Tight end Kellen Winslow spoke out about Cleveland's cover-up of his staph infection--the sixth one experienced by a Browns player since 2005--only to be suspended for one game by the team for remarks disparaging to the organization. Cleveland later rescinded the punishment because, according to The Plain Dealer, the union obtained text messages proving that the team had indeed told Winslow to zip it.

•Jets receiver Laveranues Coles, surrounded by reporters inquiring about his latest concussion--his third since December '06--said any comments he made about his injury would be considered "detrimental to the team" and added, "Unless you want to fork over some cash, don't ask me no more questions."

In setting up a concussion hotline last year, league officials basically told players to whisper if they felt they were being forced to play with a head injury. They mockingly called it 1-800-YOU-R-CUT. (The confidential phone line wouldn't have caller I.D., would it?) This player paranoia is left for the team physician to heal. "We are open and honest with them," says Panthers physician Pat Connor. "But as they know, there is also an expectation of transparency [in my dealings] with the team."

Confidentiality can get tricky. Football-related issues are transmitted to the team, but what about more personal matters? "This is where that unique situation of dual responsibility comes in," Tucker says. "If a player's medical issue--like depression--gets to the point where performance is affected, then I have the responsibility to certain people in the club. . . . Now, sometimes players will choose to share that information with other people."

So some players seek second opinions and alternative therapies--such as acupuncture or banned HGH--to expedite healing, possibly keeping the team doctor in the dark. As former Raiders physician Robert Huizenga notes, "I was surprised when I left the Raiders at how many [players] said, 'Now that you're not on the team, I really need your help.' How much was hidden from me?"