Concussions Force The NFL Into New Health Policy

The National Football League (NFL) announced a shift in the way it manages player concussions. It will now require that all 32 teams seek the expertise of independent neurologists or neurosurgeons to help diagnose players with brain injuries. Guest host Jennifer Ludden talks to Sports Illustrated reporter Pablo Torre about why NFL has made this move and what it means moving forward.

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JENNIFER LUDDEN, host:

I'm Jennifer Ludden, and this is TELL ME MORE from NPR News. Coming up, we'll give you our top picks for some good holiday-season movies. That's in just a few minutes.

But first, after you've stuffed yourself with turkey and potatoes today, maybe the next thing up on your Thanksgiving to-do list is to kick back and watch some football.

The NFL has its own holiday traditions, including games with the Dallas Cowboys and the Detroit Lions. The league also has a history of being slow to change. This week, though, marks a radical departure in long-standing policy. The NFL says it will now require teams to consult independent neurologists or neurosurgeons when diagnosing players with head injuries.

For decades, doctors employed by the teams themselves have made the decision on when or whether a player with a concussion could return to the field, but that's come under fire as a dangerous conflict of interest. On Tuesday, the co-chairmen of the NFL's Committee on Head Injuries resigned their posts.

Sports Illustrated reporter Pablo Torre joins us now to talk about all this. Welcome.

Mr. PABLO TORRE (Reporter, Sports Illustrated): Hi.

LUDDEN: So Pablo, this season alone, there seems to have been a slew of marquis players that have been knocked out due to head injuries. Can you give us a rundown of some of the big names that have been sidelined by concussions?

Mr. TORRE: Sure. I guess the biggest name most recently, and kind of might be the time peg for this kind of policy change, is Brian Westbrook. He's a guy on the Philadelphia Eagles, a marquis running back, who had a concussion, actually sat out two weeks and then came back and received another concussion´┐Ż

LUDDEN: Ouch.

Mr. TORRE: ´┐Żas soon as he returned. And so, I think that's kind of a wake-up call, even if they didn't buy the mountain of evidence that's already been mounting towards the dangers of concussions and the long-term health effects.

LUDDEN: The NFL and current commissioner Roger Goodell has long resisted having outside doctors involved in this. And on Sunday, now, he spoke about the change on NBC's pre-game show, "Football Night in America," but he still defended the old policy. Let's listen.

Mr. ROGER GOODELL (Commissioner, National Football League): I don't think there's anything wrong with it. But again, as we learn more and more, we want to give our players the best medical advice, and I think this is a chance for us to expand that and to bring more people into the circle to make sure we're making the best decisions for our players in the long term.

Mr. TONY DUNGY: Did the players ask for this? Was this input from the players, too, or not really?

Mr. GOODELL: Not specifically, coach, but they did - you know, they've always talked about the concussions. And one of the things I've always stressed to them is help us identify the players when they do have some type of a head injury and identify those so we can get the proper medical care to them, not so they make the medical decisions, but they can identify a player who needs to see medical personnel.

LUDDEN: That was NFL commissioner Roger Goodell speaking to Tony Dungy on NBC. Pablo, Goodell said the change didn't come from the players but, as I understand it, the players union has been really pushing for this.

Mr. TORRE: Yeah, the players union has come out in favor of it, and it's hard to imagine that the players union did not have input on this. I mean, it makes all the sense in the world that they'd want the best possible care. I mean, one of the great ironies of the NFL, even dating back to the creation of the league, was kind of health care.

You know, this is the richest league in the world as far as money goes, as far as fame and wealth goes, and to have players not have access to the best doctors, when it's also the most dangerous marquis sport, has kind of been mystifying to a lot of people who have been watching the game.

LUDDEN: Well, best doctors or doctor with their best interests in mind.

Mr. TORRE: Right, right. And that's a big distinction, also.

LUDDEN: I mean, there's also a congressional hearing on this last month. How influential was that?

Mr. TORRE: That was big. I mean, the public pressure started mounting. You know, when you hear the comparison to big tobacco and anti-trust, that is not good. I mean, that's something that certainly agitates the league to make it change, and the culture, the culture of team doctors was problematic.

You know, on an empirical level, we have seen what's happened to the league and to the players as far as the medical science behind it, how bad concussions are. But also as you indicated before, conceptually, I mean, the team doctors wear team apparel. You know, it's hard for a player to feel welcome and feel safe in a medical culture where their doctors are employed by their employers, and the doctors kind of are beholden to the men who pay their paychecks.

You know, it's a two-way street, also. These players might not be as forthcoming. You know, they don't want to be seen as damaged goods. They want that independent opinion to sort of get the best advice for their health.

LUDDEN: Well, and now, we're still not getting at what some see as the heart of the problem here, which is that many players have admitted they themselves hide their concussions because they don't want to be sidelined.

Mr. TORRE: Exactly. You know, the other side of the coin in this is that yes, they're dangerous; yes, players want the best care. They want to know when their health is at risk. But they want to make money. They want to play. This is their livelihood.

And so one of the ways to circumvent that problem and sort of the full disclosure aspect is to, yeah, take the team doctor out of the picture, make it so there's at least this increased culture of confidentiality. Obviously, if a player will have a concussion that puts him at risk, you don't send him out there, even if he wants to disregard it. But I think that culture of medicine that normal people are accustomed to does not exist in the NFL, which certainly creates another barrier to getting the best information out there for a player's health.

LUDDEN: Okay, so we've been told the teams must consult outside medical doctors here, but how is this going to work?

Mr. TORRE: Well, the nitty-gritty, the mechanics of it is still being formulated by the league. They haven't released a formal, detailed statement on that. But the idea is that whenever a player gets a concussion, whenever a player has a head injury, the team will be forced to consult an outside expert, a specialist, a neurologist.

One solution might have them actually on the sidelines as sort of part of the first line of response. But really, I mean, that's a question that's still up in the air. I think the issue of payment is an issue, as far as whose pockets will the money come from in order to pay these doctors. But I think the bottom line is that teams will be forced to consult an outside specialist beyond their own resources because, for the reasons we sort of mentioned before, one is the specialty of the doctor at hand; and two, to get that independent verification that would be unclouded by the relationship and the dynamic between an ownership and its employee, in this case the team doctor.

LUDDEN: But if the NFL isn't supposed to pay the doctors, do we know who is?

Mr. TORRE: We don't know that detail yet, but that'll be interesting. I think, you know, one of the options that's been long-floated, that we've written about in SI, is to sort of even scrap the idea of team doctors altogether and just make them a league-union cooperative. That would be one solution that could circumvent that issue. But again, we're not sure yet. But I would hope that there would be the removal of that conflict of interest.

LUDDEN: Pablo Torre is a reporter for Sports Illustrated and a regular in our Barbershop segment. He was kind enough to join us from our New York studios. Thank you so much, Pablo, and Happy Thanksgiving.

Mr. TORRE: To you, as well. I hope we can enjoy the games.

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