The Larry Nassar sexual assault case was a life-altering journey of heartbreak for his victims and a scandalous and hugely disappointing blow to the field of sports medicine. And it has illuminated the distressing fact that the moral compass of sports medicine (perhaps all of medicine) is off. After more than 150 young women bravely came forward with their stories of Nassar’s sexual assault spanning more than two decades, the result was concurrent convictions and a sentence that will leave this disgraced doctor behind bars for the remainder of his life. But the story isn’t over for his victims, nor should it be for the rest of us in the medical community. We have major lessons to learn here, and we have to put in the work to ensure this never happens again to the most vulnerable among us who entrust their doctors to “first do no harm.”
It’s clearer now than ever before that the trusting relationship between physician and athlete (or any patient) has been tarnished and violated. Like the feeling of relief when a police officer shows up to a crime scene, patients have long held an innate feeling of trust in and comfort with physicians, believing that we possess the knowledge and the morality to always act in the patient’s best interest. But what happens when this agreement is broken? Sexual assault in the doctor’s office disguised as medical treatment robs patients of trust and leaves them confused, helpless and broken. As more and more allegations become known, it’s a calling for all medical professionals to reevaluate the ethical standards in our arena. Denouncing Larry Nassar and his preying upon young female athletes with our words alone is simply not enough. No, this requires physicians throughout the country to act so that we can ensure nobody has to endure this type of emotional pain again.
[See: How to Find the Best Mental Health Professional for You.]
But in order for a tide change to work in each patient’s favor, action needs to come from both sides: the physician and the patient.
In the sports medicine world, there will always be ethical challenges, and this fact probably won’t ever change. Sports medicine specialists are under particularly high pressure due to the public attention focused on our patients, and this is why it’s of the utmost importance for physicians to establish a moral baseline and code of conduct to follow in every circumstance when questions may arise on how to proceed. Practicing medicine morally not only includes the physician’s personal actions, but encompasses the responsibility to report suspected patient abuse to the proper authorities as soon as it becomes known. Witnessing a fellow physician mistreat a patient or possessing the knowledge that it has occurred and not speaking up is just as bad a breach of trust (and now illegal) as if they had performed the malpractice themselves. Inspired by the national outrage from the Larry Nassar case, a bill mandating adults associated with Olympic and other amateur sports organizations contact law enforcement or child welfare authorities within 24 hours of learning of suspected abuse was passed through Congress recently and has advanced to President Trump’s desk.
[See: 10 Concerns Parents Have About Their Kids’ Health.]
It is up to sports medicine physicians to hold each other accountable to rebuild the solid and steadfast trust between the physician and patient and to encourage patients to have a strong voice in their treatment.
Sometimes it’s tough for patients to speak up for themselves. In deference to and out of respect for physicians, perhaps they silence their inner voice. I’m here to tell you that this is no time for silence. Interaction with a physician should always be a two-way street, with the physician supplying the “medical expertise” and the patient filling in the personal details and sharing his or her goals for treatment. A physician-patient relationship should be 50/50, and patients must feel empowered and know that it’s crucial to ask questions about any recommended treatment or procedure that doesn’t sit right with them. The patient is his or her best advocate, and good physicians will not only accept this, they’ll encourage it.
I understand it can still be difficult to speak up in times that call for it. These ABCs of patient/physician communication can help serve as a guide:
Ask questions. If you don’t understand something the doctor tells you or a treatment he or she suggests, ask them to clarify it in language that makes more sense to you until you feel you understand it completely.
Be prepared. Before a visit, write down major concerns you have and address each one during your visit. Having this written down beforehand makes it less likely you’ll forget and also allows the physician time to cover all the bases, as opposed to remembering a question as he or she is walking out the door.
[See: 10 Questions Doctors Wish Their Patients Would Ask.]
Communicate concerns and desires. This one is the most important, and the point patients struggle with the most. Communicating not only means asserting yourself if there’s an issue you want your doctor to cover, but also if you’re dissatisfied with the care you’re receiving.
The above recommendations aside, please remember this: If something about your interaction with a physician just doesn’t feel quite right, even if you can’t put your finger on what it is, always, always go with your gut. You are free to walk out of an exam room without having to commit to any type of treatment that doesn’t seem appropriate for your medical concern.
Ensuring appropriate and ethical health care in medicine requires outstanding moral courage, wisdom, the utmost integrity from physicians and fully supporting patients to stand up for themselves any time their voice needs to be heard. Overcoming the breach in trust that has shrouded the current sports medicine world won’t be easy, but each and every physician can help daily by holding fast to our ethical values and by becoming fierce advocates for our patients’ voices in the process.
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Ethics in Sports (and All) Medicine originally appeared on usnews.com
