Sports medicine: a career for all genders?

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Dawn Thompson, covering Brighton Marathon

I am pleased to step aside from writing for the blog today and turn over the stage to Dawn Thompson, CJSM Junior Associate Editor and a member of the ECOSEP Junior Doctors Committee.

Dawn and I have a shared background in sports medicine, but she brings a unique perspective to today’s post:  she is a woman, she is young, and she is still in training.  I am none of these things!

If sports is a mirror of society, then it should come as no surprise that in our own professional world we may see phenomena such as gender bias.   And for those of us who benefit from male privilege (me), Dawn’s post is a great reminder of the differential burden our female colleagues may face when trying to perform the same job duties as a man.

Here in the USA, 2016 is a particularly poignant moment in time: the Democratic party’s presumptive candidate for president is Hillary Clinton.  Will that political ‘glass ceiling’ be shattered?  What of our sports medicine colleagues who are women?  Do they face their own glass ceilings?

I cede the dais to Dawn:

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DT: It’s 1.30am on a Tuesday morning and I am wide awake. Ideas, thoughts, concepts are racing through my mind at a rate I could only dream of during normal hours. I don’t normally suffer with insomnia but I have just completed a particularly gruelling acute medical block whereby in 4 months I have worked 8 full weekends and a total of 32 nights. So as you can see my body clock is totally up the spout. There have been times when I have wondered why I chose this profession and how compatible it is with any sort of family or social life and times when I have marveled at what I feel can be the best ‘job’ in the world.

During these 4 months, Junior Doctors like myself across Britain have taken part in 6 days of industrial action in response to the proposed imposition of a contract they felt to be unsafe and unfair to patients, themselves and the NHS. One of the many complaints with regards to the new contract was the impact it could potentially have on women taking time out for maternity or to work less than full-time to raise a family. Indeed the governments own equality analysis summarised –

“While there are features of the new contract that impact disproportionately on women, of which some we expect to be advantageous and others disadvantageous, we do not consider that this would amount to indirect discrimination as the impacts can be comfortably justified” 

I have never particularly considered myself a feminist but I do expect a fair contract and I don’t expect to be treated any differently to my male counterparts based on gender rather than clinical acumen.

Data derived from the Health and Social Care Annual Workforce Publication 2014 showed that 57% of all doctors in training are female.  However things have not always been this way, in 1985 the year I was born, women made up only 16% of practicing doctors in the US. Some junior doctors are concerned that an unfair contract would send us backwards in terms of women in Medicine.  Already prior to this new proposed contract, pay inequalities exist in medicine.  A study published this week in the BMJ concluded that women doctors in the US earn less than their male counterparts even after adjusting for hours of work and specialty.

So what about the role of women in Sports Medicine? Read more of this post

A Sharapova Moment

The world of sports medicine is never boring, but who knew things could get this interesting?

In the first weeks of March, there have been at least two major stories that have transcended the borders of ‘sports medicine’ and become topics of debate for the world at large — I speak of the proposed ban on tackling in schoolboy rugby (and the continued debate on tackling in American football) and Maria Sharapova’s admission that she failed a drug test at the recent Australian Open.  For both stories, the boundaries of the discussion have gone well beyond the lines of the playing fields and the walls of the academy.

Social media has seen these topics trending. The mainstream media have been profiling the issues as well.  The Economist weighed in on the debate about tackling. And this morning I found the New York Times prominently featuring Ms. Sharapova’s story, including articles on the drug meldonium [for which Sharapova tested positive] and on the issue of the World Anti-doping Agency’s (WADA) use of emails to notify individuals about changes on WADA’s banned substance list.

Many people have an opinion on the subjects.   We’ve been running a poll on this blog regarding the issue of tackling, while our friends at the British Journal of Sports Medicine (BJSM) have been running a Twitter poll on the Sharapova issue: who is responsible, the player or her support staff [currently the poll is 74%/26% stating it’s the athlete’s responsibility].

In the New York Times article and in the BBC, former WADA-president Dick Pound has stated his opinion that Sharapova’s failed drug test was ‘reckless beyond description.’

I must say I take issue with this and empathize with Ms. Sharapova, who stated that she received in December the WADA email noting that meldonium was now on the banned substance list, but “…I did not look at that list.”  Meldonium was a PED legal until 2016, when it was placed on the ‘banned substances list.’ As a professional inundated with emails, alerts, pronouncements, and more, I confess to a certain degree of information overload even when it comes even to items vital to my licensure and ability to practice.  Have I ever received an email from the Medical Board that I have deleted?  Have I ever received notification from my hospital staff office of some new change in policy which I glossed over?  Yes and yes.

Regarding the WADA emails, other athletes in the NY Times article have offered this opinion: “Some dismissed the messages as irrelevant to their own regimens or too complicated to be useful.”  That certainly resonates with me and my professional world.

I am not writing this to absolve Ms. Sharapova, and I applaud her for her prompt and open admission of personal responsibility. That stance is right and proper.  But I would hardly deem her action “reckless beyond description.”

In CJSM we have published over the years several studies on banned substances. One of the pieces of original research just published in our March CJSM sheds some further light on this issue, I think: Dietary Supplements: Knowledge and Adverse Event Reporting Among American Medical Society for Sports Medicine Physicians.  Read more of this post

Team Physicians: On your mark, get set….go!

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The sidelines–where so many of us like to be.

It’s still full-on summer in North America. The temps can exceed 40 C (104 F) in some parts, and the geese haven’t flown anywhere…..but fall is in the air, as team sports are in the midst of two-a-days and the hitting has begun! My clinics have shown an uptick in patient numbers, as the injured are trickling in. I have yet to stand on a sideline, but will do so in two weeks. It’s a good time to review the Team Physician Consensus Statement (see below) published a couple of years ago.

From the challenges of making real-time, sideline decisions regarding our athletes to the development of emergency action plans, those of us in clinical sports medicine will find a lot to help us in this statement.  In CJSM we have published over the years several manuscripts of great importance to the team doc.  We have explored whether return to play decisions are the responsibility ultimately of the team physician to variation in physician practice in those return to play decisions to more.  On this blog, we’ve covered the spectrum with interviews of team physicians from the Ohio State Buckeyes (Jim Borchers) to the Michigan Wolverines (Bruce Miller)…….

The health and welfare of our athletes is our primary obligation; in keeping our eye on this ‘ball’ there are several others we need to juggle–the needs of the team, the decisions of coaches and managers, the desires of parents if we are taking care of youth athletes……As our seasons progress, be sure to follow us here on the blog and on twitter @cjsmonline. And stay tuned to cjsportmed.com for studies released ahead of print, our ever-growing body of podcasts. We will try to help you navigate this juggling act.  All the best!

Clinical Journal of Sport Medicine Blog

Earlier this week, several sports medicine organizations released a statement with which all sports medicine clinicians should familiarize themselves:  the “Team Physician Consensus Statement:  2013 Update.”

The Statement represents, in its own words, “…an ongoing project-based alliance” of the major professional associations associated with sports medicine  in the United States.  These include the American Academy of FamilyPhysicians (AAFP), the American Academy of Orthopaedic Surgons (AAOS), the American College of Sports Medicine (ACSM), the American Orthopaedic Society for Sports Medicine (AOSSM), the American Osteopathic Academy of Sports Medicine (AOASM), and this journal’s affiliated professional group, the American Medical Society for Sports Medicine (AMSSM).

This is an update of a statement first published in 2000.  It includes sections which define the role of ‘team physician’;  describe the requisite education and qualifications; enumerate the medical and adminstrative duties and responsibilities; and explore the relevant ethical and medicolegal issues.

The entire statement is worth a read, but I find…

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Beantown & the MomsTeam Summit

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With the illustrious Brooke de Lench, Executive Director of MomsTeam. Friend and fellow traveller in the quest to make youth sports safer.

I’m flying to Boston today, and it feels like going home.

As I’ve shared with readers of this blog, I spent many of my formative years of education and medical training in ‘Beantown.’  I’ve experienced both sports (university track and cross-country) and sports medicine (fellowship training, coverage of the Boston marathon, and more) in ‘the Hub.’

This morning I head to Boston in advance of attending and speaking at a very special gathering taking place on Monday:  a ‘Youth Sports Summit’ taking place at Harvard Medical School.  The summit will focus on evidence-based best practices to address almost every facet of #YouthSportsSafety:  concussion prevention, sound nutrition, screening for sudden cardiac death, prevention of sexual abuse, to name a few topics.  I am one of several speakers and I’ll be speaking on injury prevention in youth athletes.

The host for the “Smart Teams Play Safe” summit is MomsTEAM  an especially influential organization addressing #YouthSportsSafety concerns. I serve on the Board of Advisors for the non-profit MomsTEAM Institute.  The Board is full of authors who have published in CJSM:  Tracey Covassin, Neeru Jayanthi, Dawn Comstock, Johnana Register-Mihalik……it’s a veritable ‘Who’s Who’ of sports medicine.  Most of the Board will be in attendance, and many will be speaking.

As I prepare for my talk, I find myself so frequently turning to the pages of CJSM to find the evidence for best practices in this area.  I will be relying heavily on studies ranging from the AMSSM position statement on youth overuse injuries, published in January 2014; to the CASEM position statement on neuromuscular training for ACL injury prevention; to some of the compelling research regarding the benefits of postponing body checking in youth hockey.

I’ll be blogging and tweeting from Boston, so look to these pages and to our twitter feed for updates on the proceedings.

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Spoiler Alert (will be mentioning this in my talk):  if there is any group that is going to begin solving the epidemic of youth sports injuries, it is a determined group of mothers like those involved in MomsTeam.  From the Playground Movement of the late 19th century, to the push by MADD to address the public health crisis of drunk driving, motivated mothers have made major impacts on societal health.  I have no doubt that in the arena of #YouthSportsSafety, the same will hold true.

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