Becoming a team physician is one of the most competitive and least advertised career paths in orthopedic surgery. Professional and major college teams typically build their medical staffs through yearslong relationships rather than open job postings — a physician often starts by covering high school or college games, volunteering alongside a team’s athletic trainers and gradually earning trust before getting near a professional roster.
Most team physicians complete a sports medicine fellowship in addition to orthopedic surgery training, and many maintain a full outside practice, treating team athletes as one part of a broader patient load rather than a full-time job. The role comes with significant visibility and pressure: Sideline decisions are made in seconds, return-to-play calls are second-guessed by coaches, agents and fans, and a single high-profile injury can follow a physician’s reputation for years.
Becker’s connected with two team physicians who spoke about game-day injuries, misconceptions and approaches to treating professional athletes.
Kevin Kaplan, MD, is an orthopedic surgeon at Orthopaedic Specialist of Jacksonville (Fla.) and the head team physician for the Jacksonville Jaguars.
Elizabeth Matzkin, MD, is an orthopedic surgeon with Somerville, Mass.-based Mass General Brigham and head orthopedic surgeon for Boston Legacy FC.
Editor’s note: Responses have been lightly edited for clarity and length.
Question: How do you balance the pressure to get an athlete back on the field with the medical reality of their recovery?
Dr. Kevin Kaplan: In my experience, the best way to approach any injured athlete, whether they are a professional, collegiate, high school or even a weekend warrior, is to make sure the athlete truly understands what the injury is and to go over all the potential options for treatment. They also need to be made aware of both the short-term and long-term ramifications of the injury. If, as a team physician, I feel that the player isn’t putting himself or herself at risk, then we can have a shared conversation on what is best for the athlete in relation to their future participation. Thankfully, I’ve been around coaches and general managers who have never challenged the medical decision-making process and support us taking care of the athletes. I always put the players’ health as the priority, and that eliminates the pressure of trying to get an athlete back on the field too soon.
Dr. Elizabeth Matzkin: Balancing the pressure to get an athlete back out on the playing field but allowing them to safely do so takes shared decision-making as well as using objective milestones. Luckily, most of our professional athletes have access to strength and conditioning coaches, nutritionists, physicians, athletic trainers, physical therapists and technology that allow day-to-day monitoring of their injury. As a physician, our No. 1 job is to protect the athlete from a physical and health standpoint. So although there may be pressure to get an athlete back out on the field as soon as possible, as a team physician it is our job to make sure the athlete is safely ready.
Q: How does treating a professional athlete change your approach compared to a general patient with the same injury?
KK: The injuries we see in the NFL are the same that I see in my normal clinical practice. However, the difference is that the NFL athlete’s job, as opposed to a weekend warrior’s, is to play football on a weekly basis. So that adds a level of complexity in terms of recovery timelines. We have all the nonoperative resources available to rehabilitate injured athletes in hopes of safely and efficiently getting the player back on the field to help the team. In some cases, of course, I need to address certain injuries surgically. Having said that, the same rules apply in regard to any of my athletes, both the professionals and the weekend warriors: return to play when we minimize the risk of them hurting themselves in the short or long term.
EM: Often the treatment and approach for a general patient versus a professional athlete are very similar, except our professional athletes have access to better resources, including physical therapy, advanced modalities and more access to equipment and personnel to work with. Professional athletes also have the advantage that being physically fit is part of their job, which gives them an advantage when it comes to getting back to a high level of fitness and function after an injury.
Q: What’s the biggest misconception people have about being a team physician?
KK: People think that being an NFL team physician only involves game-day coverage. However, there is so much more that goes on from the minute the game ends until the next one starts: post-game injury checks, clinical evaluations throughout the week, MRI reviews, conversations with agents, athletic trainers, coaches and general managers, and being on call for the team at a moment’s notice for new injuries, free agent physicals and player updates regarding game status. While I maintain a busy clinical practice, the NFL job is a tremendous time commitment that is largely behind the scenes.
EM: The biggest misconception is that it is easy and fun to watch the game from a great seat, whether it is on the field, on the court or in the rink. In reality, it is somewhat stressful to watch the game because we are constantly monitoring all the athletes, as well as trying to pay close attention in case a new injury occurs. From the sidelines, we are quietly and closely monitoring athletes who have just returned from an injury, athletes who are coping with an injury, athletes who have a medical history that may be concerning, and we are always on high alert for any potential new injury.
Q: What does a game-day emergency actually look like from your side?
KK: Prior to the start of the season, we rehearse game-day emergencies with all of our staff, including athletic trainers and emergency personnel. We go over a large number of scenarios in real time so that everybody knows what to do in case of a game-day emergency. Once the scenario is complete, we debrief to talk about what we liked and what we need to change. Sixty minutes before every game at every stadium, we have a medical meeting to go over game-day logistics, which involves all medical personnel. The home team goes over the protocol for emergency situations at their stadium. All of these things prepare us for the unfortunate emergencies that present themselves each week. My goal when evaluating an injured player is to first get them to take a breath and give them the confidence that the athletic trainers and I have everything under control. The game-day environment is hectic, so being able to keep the situation calm is a high priority.
EM: We actually practice for game-day emergencies on a regular basis. There is also always a medical timeout/meeting before the game between the physicians, athletic trainers, operations staff and the EMTs/paramedics to make sure we are all well prepared for any emergency that may occur on game day. We have hand signals and understand each person’s role, so if or when something happens, we can immediately get to work to stabilize and care for the athlete.
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