In the first installment of this series, we explored how physicians can protect themselves against potential medical malpractice liability when providing volunteer physicals for schools during the back-to-school season. While this is a common practice for many physicians, some take this a step further and continue to provide their services throughout the year as the on-site team physician for local sports teams.
While valuable, volunteering services opens physicians up to an array of risks that can be mitigated with proper planning.
According to the U.S. Centers for Disease Control (CDC), nearly 30 million children and adolescents participate in organized youth sports in the United States, and as the number of athletes continues to rise, so too does the number of sports-related injuries. Each year, high school athletes account for an estimated 2 million injuries and 30,000 hospitalizations, and more than 3.5 million children under the age of 14 receive medical treatment for sports injuries.
While physicians providing volunteer physicals should follow all of the steps outlined in the first installment of this series to prevent a lawsuit, those supporting sports teams need to take a few additional measures to protect themselves:
- Define the scope of services. Physicians should sign a team physician services agreement with the school or governing body as well as each of the individual athletes to define the role in its entirety. In these documents, the doctor will need to outline their services in writing and provide a copy of this agreement to his or her malpractice insurer to confirm coverage. Click here to view a resource for developing such an agreement provided by the National Athletic Trainers’ Association.
- Perform preparticipation medical screenings. At the start of the season, the physician should perform an initial screening for each of the players to determine whether or not the individual is fit to participate in the sport. During this examination and for all interactions following, the physician should follow reasonable standard of care as would be expected given the location, available tools, and scope of services. Should the physician find a player unfit to participate, he or she should then recommend that the athlete schedule and in-office visit with their primary doctor or an appropriate specialist.
- Do the necessary research. When working with a travelling team, physicians must be sure to brush up on the local law before providing services across state lines. Many states will not allow physicians to practice medicine without the proper licensing, while others have exceptions for activities involving athletes. If the physician is unsure, he or she can contact their malpractice insurer for legal advice and to confirm that the professional liability policy doesn’t exclude coverage for this activity.
- Don’t let the opinions of parents and coaches override medical judgment. Those who have an emotional stake in the outcome of the match may have clouded judgement when it comes to the medical care and safety of the players. Physicians treating teams must rely on their own expertise to decide immediate care, whether that means slapping on a bandage and sending them back in or keeping the player on the sidelines for the remainder of the match. If an athlete is unfit to return to the game yet is cleared to do so by the physician, the doctor may become liable for any further injury sustained. In emergency situations, the physician should call 9-1-1 and provide basic care to make the individual comfortable until turning the patient over to emergency responders once they arrive.
- Document all interactions. Physicians should appropriately document all instances of medical care and maintain records to facilitate potential follow-up care and protect themselves if there is question regarding the services rendered.
- Make sure your practice is aware of your role. If you are a physician in the practice, make sure your partners and/or the organization are aware of this activity. If you are an advanced practice professional, ensure that the practice and your supervising physician(s) are aware of and have approved your involvement.
By taking the extra initiative to follow these steps, physicians can minimize the risk of serious injury for athletes while simultaneously protecting themselves from potential legal repercussions in the wake of an adverse event. However, while this provides a core framework for the development of best practices when providing volunteer medical services, physicians should always reach out to their malpractice insurer to understand the regulatory environment as it applies to their unique situation as well as confirm individual coverage.
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