An Active Future for Primary Care Sports Medicine
THE PHYSICIAN AND SPORTSMEDICINE - VOL 31 - NO. 6 - JUNE 2003
This issue marks the official 30th anniversary of The Physician and Sportsmedicine (PSM). Over the past 30 years, PSM has published 358 issues of the journal, which adds up to about 400 million individual copies. That's a decent-sized stack.
Among those many issues, we have published an incredible array of articles on the medical aspects of exercise, sports, and fitness. Some sterling examples that immediately come to mind have been on Little League injuries (Torg 1973), women in sports (Wilmore 1974), aging (Pollock et al 1978), HDL cholesterol (Hartung and Squires 1980), hypertrophic cardiomyopathy (Cantwell 1984), concussion (Cantu 1986, Aubry et al 2002), myositis ossificans (Estwanik and McAlister 1990), hypertension (Tanji and Batt 1995), tendinosis (Khan et al 2000), cancer (Courneya et al 2000), and stretching (Shrier and Gossal 2000).
PSM's goal is to remain at the forefront of providing primary care information that promotes health through physical activity. But consider this irony: While many of the advances in medicine that hold promise for disease treatment are technological, many of the current health problems are lifestyle related. For example, obesity in children and adults is now considered by the Centers for Disease Control and Prevention to be an epidemic in the United States. How is it possible to have technology at our fingertips and to continually gain new knowledge about the health risks of obesity, yet have an epidemic develop right under our noses?
While medicine probes deeper into technology to improve treatment (eg, automated vein graft procedures for coronary bypass), sports medicine remains one of the main disciplines that promotes health at an integrative, whole-organ level. In part because the benefits of regular exercise are so powerful (eg, sedentary living is one of the main risk factors for coronary artery disease), sports medicine is poised to be a key player in primary care prevention and treatment for years to come.
One example of the prominence of primary care sports medicine is at the American College of Sports Medicine (ACSM). The ACSM for years has played an instrumental role in promoting and disseminating research results on exercise and health. This year, the college, with its more than 20,000 members, elected as its president William O. Roberts, MD, a well-respected primary care physician and long-involved PSM editorial board member. Bill is the first primary care physician to be named ACSM president. In addition to the accolades Dr Roberts deserves, I would add that his election signals a fundamental change in the way we see the delivery of sports medicine services.
Primary care practitioners, empowered with the knowledge and skills to provide care for a physically active population, are going to become more and more essential in the next two decades. Enough good research already exists to take action on the sedentary epidemic—action likely to be in the trenches of primary care. Equipping primary care physicians with the expertise to handle sport injuries, therapeutic exercise, and musculoskeletal medicine guarantees a population of physicians certain to stand on the front lines of lifestyle-related diseases.
As we look forward to the next 30 years of PSM, we see exciting developments. We'll witness more translation of existing research into the practice paradigms of primary care. Also, in spite of great technological advances, more and more healthcare professionals will recognize the importance of sports medicine's relatively low-tech optimization of human performance and health at all ages and in all groups. It's an exciting time for the field, and for the journal.