Sports Medicine's Primary Focus: Health for All
THE PHYSICIAN AND SPORTSMEDICINE - VOL 31 - NO. 12 - DECEMBER 2021
From a primary care perspective, I believe the philosophy that "every patient is an athlete" sums up the changes in sports medicine since the advent of this journal. The emphasis has changed in three decades from "Johnny's ruin't knee" to the importance of exercise for general health and the inclusion of the entire population. Sports medicine treats competitive athletes, but it also crosses into the realm of activity and health.
Just under 30 years ago, as a student at the University of Minnesota School of Medicine, my options for sports medicine training were nil. The field was considered the domain of orthopedic surgery, and few in primary care were visible in the sports medicine community. Most nonorthopedic sports medicine textbooks were generated in Eastern Europe and generally not available in English. There was little formal course work pertaining to the care of active people. This was also true during my family practice residency years in the late 70s, although change was in the works. During interviews for residency, the topic of sports medicine was of interest to the program directors, and it was obvious that family practice was ripe for change.
As a resident, I began working on the sidelines of sports events, usually at the high school level. The first question from coaches, athletic trainers, and administrators was, "Where do you do your surgery?" It took some exposure to gain credibility. In my third year of family practice residency, I thought an extra year of sports medicine training would benefit my professional goals and my patient care. The fellowships I was able to contact laughingly said to come back in 5 years when I had finished my orthopedic training.
The acceptance of primary care sports medicine on the sidelines and in the locker room has signaled a major change in the field. The relationship between the disciplines has evolved from sometimes hostile to generally peaceful coexistence to mutual cooperation and respect—as evidenced by the productive work of the Project Based Alliance coordinated by the American College of Sports Medicine. This alliance comprises the major organizations from all specialties who have produced the Team Physician Consensus Conference Statement series.
Educational opportunities in sports medicine have skyrocketed, and faculty has improved from self-proclaimed sports medicine providers to experience-based and fellowship-trained physicians with evidence-based data to support their teaching. Exposure to sports medicine comes earlier in physician training, and options for extensive training and a subspecialty board have evolved over the last 30 years. Twenty years after my search for a suitable fellowship, third-year residents can choose among many primary care fellowships.
Approaching every patient with the principles of activity as a basis for health opens the field to the entire population. Be it rapid return to work or shedding pounds, exercise is cheap and easy medicine.
In looking to the future, I believe the public will demand that primary care physicians be even better trained in the care of active people of all ages. Medical schools and residency programs will incorporate more sports medicine studies, and a specialty board in sports medicine will evolve and have its own residency positions and board testing. Healthcare professionals and athletes will have to wrestle head-on with the scientific advances that can be used to improve performance.
The excitement of the past 30 years will not wane in the next three decades. The scientific inquiry and evidence-based approach to modern sports medicine is the single greatest achievement in the sports medicine world. As we wrap up this 30th anniversary year for The Physician and Sportsmedicine, the luster of exercise medicine could not be brighter.