League defends absence of independent neurologists during games
The NFL informed PFT on Wednesday that independent neurologists are not present during games to control the determination of whether a player should, or shouldn’t, return to action after possibly suffering a concussion.
On Thursday, NFL spokesman Greg Aiello provided some additional information regarding the in-game medical arrangements.
“Given the fact that teams are mandated to have board-certified medical physicians and athletic trainers on each sideline that have been trained to recognize and triage a wide range of medical issues, including concussions, we have complete confidence in our medical staffs to follow the guidelines,” Aiello said via email. “It is no different than an orthopedic doctor making a diagnosis of a fractured spine and then the spine specialist takes over. . . .
“The doctors and athletic trainers are fully trained to diagnose concussion. It is also important to note that because team medical staffs know the players so well they are in excellent position to observe changes in behavior that may be symptoms of concussion. The role of the outside neurologist is to guide the treatment and return-to-activity decisions of a player removed from play or practice with a concussion. The player cannot return to practice or play until clear by the neurologist.”
The explanation, while both thorough and helpful, doesn’t account for the possibility that team-hired physicians will not err on the side of caution when assessing whether a player has suffered a concussion during a game, given that they are hired by the team. The “WHEN IN DOUBT, LEAVE THEM OUT” memo mandates removal from play when there is “any suspicion” that a player has suffered a concussion. Surely, there was at least some suspicion that Eagles quarterback Mike Vick suffered a concussion on Sunday against the Redskins. A rule that would prevent a player in that situation from returning to action until cleared by an independent neurologist would help eliminate media and fan suspicion that the team’s official diagnosis -- “dirt on the face” and, later, having the “wind knocked out of him” -- was aimed at concealing the possibility that a concussion had been suffered.
The fact that the NFL uses independent neurologists represents an implicit acknowledgment that independence is needed in order to best navigate the tension between player safety and the on-field needs of the team. In the wake of the handling of both Vick and Lions running back Jahvid Best (who returned to action after banging his head on the ground and then was diagnosed with a concussion based on symptoms that somehow didn’t appear until an hour after the game), it seems prudent and appropriate for the league to find a way to inject true independence into a heat-of-the-moment process that could prompt team-hired doctors to succumb to the traditional pressures and tensions that have resulted over the years in plenty of injured players “rubbing dirt on it” and returning to action.