Why sports medicine requires a team approach

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Sports medicine surgeon Thomas Graham, MD, has treated numerous professional athletes and approaches their care through a three-pronged lens.

Dr. Graham, physician-in-chief at Allentown, Pa.-based Lehigh Valley Orthopedic Institute, spoke with Becker's about his strategies when it comes to athlete care.

Note: This conversation was edited for clarity and length.

Question: You've operated on multiple professional athletes and obviously many more general population patients. How do you approach your conversations when it comes to risk and getting the best outcomes possible?

Dr. Thomas Graham: I'll first say that we've been the beneficiary of participating in the care of more than 2,500 professional athletes, and they've been the greatest laboratory to advance our understanding of the limits of surgical science. These are individuals who have great biological and chemical makeup. They're incredibly dedicated. We have every resource in the world to take care of them. We learned so much about restoring people to the 100th percentile. We've been really proud of transporting so many learnings from the care of the professional athlete now into the care of our neighbors who are attorneys and schoolteachers and factory workers and things like that. 

Obviously, there's risk involved in every surgery. We have to clearly communicate that. That's why we've been the beneficiary of working within an ecosystem of incredible professionals including the head athletic trainers and other team physicians. Sometimes we have to rely on colleagues in the industry for special implants, but we've been working at this now for three decades, and we've really tried to add to the science of the care of athletes and active people and then also continue to advance it. 

We get this opportunity to get a glimpse into a very unique set of our population, and we bring that same rigor to everybody we see. But this has been a very unique laboratory for us. We've been very fortunate. Medicine is a team sport. You learn a lot about the reliance on so many colleagues that surround these athletes. You got to give the athletes themselves so much credit for their dedication and the things that they do that put us in awe in the field and the ice and the court. But it just also teaches you what a championship organization is all about. So there's a lot to learn from my three decades in professional sports that I'm really proud of. 

Q: Dr. Neal ElAttrache spoke with Becker's about Tommy John surgery and how it's evolved with the demand on baseball players. How do you see the procedure evolving? Are you concerned about these increased demands on players, not just in baseball, but in athletics in general? 

TG: Dr. ElAttrache has great humility when he stated that it hasn't changed that much in 50 years. He was honoring the people that went before us, and we all benefit from their activities. He does some things a little bit differently than we do. That's why we collaborate so much. I send him a certain selection of patients, and he sends me hand and wrist patients because we're very specialized. I don't do Tommy John surgery; I send those patients to Dr. ElAttrache. 

But there are correlates in our business. It starts really with an understanding of your role, and we published widely on the role of the specialty consultant and professional sport. What we try to get across is you're taking care of a person. His job is a player, but that day he's a patient, and you have to approach it that way. I think to an extent, that's why so few people do so much professional sports care is because it's a very demanding place to be. 

We have to understand the special demands of their profession, which happens to be a sport. For me I look at the hand intensiveness that each position on each team is doing. What is that player doing when he's rebounding the basketball or shooting the hockey puck or defending the quarterback on the line?

We then think about three time periods. This is the discussion I have with every single one of our athletes. Short-term is the season, medium-term is your career, and long-term is playing with your grandchildren. We have to make good decisions that honor each one of those time periods. We can't do anything that jeopardizes the continued ability for that individual to play just because we think that next game is so important. That's the role of the team physician or the specialty consultant in professional sports. Yes, we protect, but we collaborate. And to be honest, I've been so lucky. I've had so few instances where we've been at cross-purpose, and that comes from the thing that we all strive to be as communicators. 

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