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Emergency physicians are widely recognized as having a broad base of training comprising virtually all elements of acute care medicine, as well as encompassing certain elements of primary care. This diversity in training and expertise can be very helpful when considering practice diversification opportunities. Opportunities for diversification may be helpful when addressing the attrition of physicians in emergency medicine. This attrition has been attributed to a wide variety of causes, including shift work, psychological stress, and other factors.1-6 In addition, emergency physician groups may look for avenues of diversification to obtain additional income sources and to engage in areas personal interests and expertise. Sports medicine offers an important opportunity for these groups as emergency physicians are well trained and comfortable with the acute care aspects of evaluation and treatment of athletic injuries and illnesses.

Sports medicine is traditionally considered the domain of the orthopedic surgeon, but has become more accessible to physicians from other specialties. Sports medicine fellowships are increasing popular to physicians other than orthopedists, including family practitioners and emergency physicians. Over the last 15 years, the primary care sports medicine fellowship programs available for emergency physicians have grown significantly. Sports medicine in the context of this chapter is a broader topic than just team physicians. Most physicians think of sports medicine as being limited to acute injury care, physical rehabilitation, and some aspects of preventive medicine as well, with most of the expertise in this area traditionally lying within the practice of orthopedic surgery. The role of a team physician may include, but is not limited to these areas. Venue medicine is another area that can be included within the sports medicine arena; however, it often receives little attention within the physician community.

As a specialty, emergency physicians are uniquely trained to handle all emergencies whether minor or major. In sporting events, care for both the spectator and the athlete often includes primary orthopedic injuries, as well as general medical problems including life-threatening emergencies and traumatic injuries. This may include airway problems, head injuries, cervical spine injuries, cardiac arrest, cardiac arrhythmias, respiratory distress, intra-abdominal trauma, dehydration, heat illness, allergic reactions, and even the diagnosis and treatment of dermatologic diseases. In many events, care of the athlete has typically been the orthopedist's responsibility, and emergency medical services (EMS) and/or nurses have delivered spectator care.

All too often, spectator care receives minimal physician involvement. Frequently, the choice of physicians to provide spectator care has not been based on knowledge and ability, but simply acquaintance with the event organizers. With an increased emphasis on risk management and professional liability, consideration and selection of physicians to provide spectator care has become more important. The opportunities in sports medicine for the emergency physician are vast. The biggest obstacle has been the issue of reimbursement. In many cases, both as physicians for teams and spectator care, the medical community is often called upon to simply donate their time. Addressing the question ...

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