Independent MDs needed in the NFL, report says

League denies any conflict of interest exists

A new report from Harvard Law School proposes drastic changes in the way health care is administered in the NFL, urging the nation’s most popular sports league to upend its system of medicine and untangle the loyalties of the doctors and trainers charged with treating players.

The 493-page report outlines a new system in which a team’s medical staff is devoted solely to players’ interests and no longer reports to team management or coaches.

“The intersection of club doctors’ dual obligations creates significant legal and ethical quandaries that can threaten player health,” the report states.

The two-year study bills itself as the first of its kind in “examining the complicated and often-paradoxical universe of stakeholders that may influence NFL player health.”

The NFL strongly took issue with the methodology and conclusions drawn by the Harvard researchers.

Jeffrey Miller, the NFL’s executive vice-president of health and safety, rejected any suggestion that NFL doctors have conflicts of interest and called the proposed change “untenable and impractical.” He said researchers have called for “several unrealistic recommendations that would not improve player care.”

The report “cites no evidence that a conflict of interest actually exists,” Miller wrote.

“The report identified no incident in which team physicians were alleged to have ignored the health status of players, failed to adhere to patient confidentiality consent procedures, or made recommendations to clubs that were contrary to the health of players.”

The report — called Protecting and Promoting the Health of NFL Players: Legal and Ethical Analysis and Recommendations — is authored by members of Harvard Law School’s Petrie-Flom Center for Health Law Policy, Biotechnology and Bioethics. It is part of a multi-year, multi-million-dollar project that includes several Harvard studies examining the wellbeing of NFL players. Though funded by the NFL Players Association, the research is independent, and Harvard officials stress neither the union nor the league has any control over the studies.

Harvard researchers say they were surprised by the league’s response. “I had expected we’d maybe be quibbling around the margins of how it would actually be implemented,” said Holly Fernandez Lynch, executive director of the Petrie-Flom Center and one of the report’s authors. “I did not expect that we would have to have this conversation about whether there is, in fact, a conflict because it’s so obvious on its face.”

Players are treated by doctors and trainers hired, fired and paid by the teams. They consult with coaches and team management about all manners of player health. The Harvard report suggests players, instead, should be treated by a doctor and staff selected by a neutral committee. Though still paid by the team, the medical staff would serve solely the players’ interests, deciding whether the players should participate in practices or games.

The report says doctors and team trainers should not have communication with the team about player health.

They would instead prepare a Player Health Report, which would detail the player’s condition, playing status and level of permissible participation, among other things.

The club then would employ its own doctor to review that report and communicate with coaches and team officials.

The team doctor could perform pre-employment physicals and also examine players during the season. Despite two attempts, researchers were denied access to team employees, including coaches, doctors and trainers.