NFL Draft: a team doctor's role

In late February, the medical staffs of all 32 teams make the annual trek to Indianapolis for the NFL Scouting Combine. Approximately 335 college football players are invited to the Combine. The players have 15 minute interviews with the coaches and GMs, they participate in various workouts but the most important aspect of the Combine is the medical examinations. The athletes could refuse to workout but they cannot refuse a physical examination.

The players go through a medical and orthopaedic examination. There are six orthopaedic rooms each with 5-6 teams per room. The original Combine was made up of the Eagles, Bears, Lions, Steelers and Dolphins only. The NFL has kept these teams together in the same room and recently added the Texans. The Eagles do not give me a list of players that they are specifically interested in the draft, they want me to exam every player the same because you never know how the draft will progress.

The examinations are spread out over 4 days:

The players enter the room in bare feet wearing only shorts carrying their medical record and completed diagnostic studies. A physician takes a more complete history, examines the player and orders any additional tests such as x-rays and MRIs. There is no such thing as cost containment at the Combine. It is not unusual for a player to undergo 3-4 MRIs of different body parts. After this initial examination, each team applies a grade for that player. I have found that every player is very humble and cooperative no matter if they are projected to be the overall number one selection or Mr. Irrelevant, the last player chosen in the draft.

Once the Combine is over the athletic training staff assembles all the MRI reports, lab results and EKGs. A file for each player is created. I have access via a website to review all x-rays, MRIs and CAT scans. I review all studies that were ordered on every athlete and give them a final grade. Every team has their own arbitrary grading system but is basically no risk, low risk, moderate risk, high risk or disqualified. We share our grades with other teams and they in turn give us their grades.

During this process, free agency is proceeding. The team notifies me a day before the player is scheduled to visit. The 24 hours prior to that visit we scramble to gather as much information as possible. Every NFL player signs a release to allow transfer of all medical data. Based on this information, we schedule diagnostic testing so that it will be available for my review when I examine the player. The visiting free agent is on a tight, rigid schedule with tours of the city and meetings with coaches. Just like the Combine, the player goes through a medical and orthopaedic exam. After reviewing all the data, I then call the GM and give him my recommendation whether the player is medically cleared or there is too much risk in signing this particular player. Conditions such as a significantly degenerative joint(s), multiple failed surgeries and unstable joints are red flags that this athlete may be too great a risk to invest a lot of money for him to play.

A few weeks before the NFL draft, myself and our Internist, Dr. Gary Dorshimer, have a meeting with the Head Coach, GM, owner and athletic training staff. Even at this meeting, the team does not tip their hand concerning who they are looking to draft. We review the medical record of every player eligible for the draft. At this meeting, players that we feel are too risky are removed from the draft board. An exception to this happened in 1998 when we felt that Jeremiah Trotter was too high a risk and Ray Rhodes, the Head Coach at that time, refused to remove him from the draft board. This is just one example where all the diagnostic testing and medical knowledge cannot replace the determination and heart of a player to succeed.

though the draft is held in New York City, all the decisions and draft day trades are made at the Eagles' NovaCare facility. I am required to be present at the facility to answer any medical questions about the potential draft picks. Often, I am presented with 2-3 files on players that the Eagles may draft in the upcoming round and asked which of them is the healthiest and if that athlete is available then that is who they select.

The assembling of a NFL team is a complicated and a drawn out process with many factors that are considered; ability, character and health. Be it very small in the grand scheme of things, the medical staff does have some input into the selection process.

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