What is a sports medicine doctor? Is there such a specialty?
Anyone can call themselves a "Sports Medicine" specialist, and this can be very misleading. In the United States, "sports medicine" is not a recognized residency training specialty. However, a doctor can achieve special qualifications in sports medicine AFTER completing a residency program in another specialty.
What specialties are those?
There are two types of "sports medicine" doctors. Non-surgical, or primary care sports medicine doctors, and orthopedic surgeons. Most primary care sports medicine doctors choose family medicine as their baseline training, which means they first complete 3 years of a family medicine residency after medical school, before embarking on their additional sports medicine training. Although family medicine is the most popular choice, other choices for initial residency training prior to doing sports medicine include pediatrics, internal medicine, emergency medicine, neuromusculoskeletal, and rehabilitation medicine. Each of these are non-surgical specialties. Orthopedic surgeons must of course complete an orthopedic surgery residency.
Then what?
Then, to pursue the primary care sports medicine path, the doctor applies for a 1-2 year sports medicine fellowship program. During fellowship training for primary care doctors, a great deal of time is spent learning more about sports injuries. Time is spent in orthopedic surgeons' offices, as well as assisting in orthopedic surgery. Primary care doctors won't become surgeons, but it's helpful that they learn first hand about the various surgeries that some of their patients may need. Another important aspect of sports medicine fellowships involves being a team doctor for a local high school and/or college, gaining experience in the training room as well as on the field.
Also, since sports medicine is more than just orthopedics, the primary care sports medicine fellowship includes continued training in the doctor's original specialty, be it family medicine, pediatrics, etc. This way, they don't lose touch with their baseline training. Such doctors become very good at musculoskeletal/orthopedic injuries, but are also well trained in more traditional medical problems, such as asthma, hypertension, diabetes, etc. They make excellent overall doctors for active people or athletic teams.
So a family doctor can get additional training by doing a "sports medicine fellowship." But what about the orthopedic surgeon? Do such fellowships exist for them?
A doctor who completes an orthopedic surgery residency may also do a surgical sports medicine fellowship, which lasts anywhere from 12-24 months. Such fellowships allow the doctor to gain more experience in surgical techniques for a variety of sports injuries. However, some orthopedic surgeons elect to do a fellowship in a specific joint, such as a "shoulder fellowship." Obviously, there can be quite a bit of overlap as to who would be the ideal surgeon to treat specific sports injuries. Your primary care sports medicine doctor can often be an excellent source of information regarding surgeon recommendations.
Is there an additional examination in "sports medicine"?
For orthopedic surgeons, there is not. For primary care doctors, there is, and it is called a "Certificate of Added Qualifications (CAQ) in sports medicine." It is a rigorous examination that covers the medical and musculoskeletal aspects of sports medicine.
The two organizations that certify physicians are the American Board of Medical Specialties (ABMS), and the American Osteopathic Association (AOA) Bureau of Osteopathic Specialists. Any claim of "board certification" or "certificate of added qualifications" must be accredited by one of these two organizations.
Can a primary care doctor take the Certificate of Added Qualifications (CAQ) examination in sports medicine if they don't do a sports medicine fellowship?
Not anymore. Since 1999, a fellowship is required to even be eligible for the examination.
Can my "regular" family doctor or "regular" orthopedic surgeon treat my sports injury?
Yes, and many of them do. It would be unfair to a family doctor or orthopedic surgeon to say that they cannot treat your sports injury just because they did not do a fellowship. However, the extra training that a sports medicine fellowship provides makes a primary care sports medicine doctor or orthopedic sports medicine surgeon an ideal choice for many active people.
So who should I see first for my injury: a primary care sports medicine doctor or an orthopedic sports medicine doctor?
There are some cases that are so obviously surgical that you would be better off seeing an orthopedic surgeon first, if your insurance allows it. However, most sports injuries and common fractures can be comfortably managed by a primary care sports medicine physician. Even if your injury will require surgery, a primary care sports medicine doctor can often make this determination. As you may imagine, they also know the local orthopedic community very well in case you need a good recommendation for a surgical referral.
Do orthopedic surgeons and primary care sports medicine doctors compete for the same patients, often creating an air of ill will?
No. Most orthopedic surgeons are more than happy to get assistance in managing the many non-surgical patients that would normally be referred to them. Sometimes, patients end up being referred to an orthopedic surgeon simply because the referring doctor was unaware that primary care sports medicine doctors exist.
Some doctors are D.O.'s and some are M.D.'s. Is there a difference?
D.O.'s (Doctors of Osteopathic Medicine) and M.D.'s are considered to be equivalent degrees. D.O.'s, however, place additional emphasis on the musculoskeletal system, and also can perform hands-on manipulation (called osteopathic manipulation). This can be a very effective tool when treating various sports injuries. However, D.O.'s are not limited to manipulation, as they also prescribe drugs, do surgery, and practice a full scope of medicine. Only D.O.'s and M.D.'s are recognized by the American Medical Association as fully licensed physicians in the United States. You may click here to learn more about osteopathic medicine from our parent organization, the American Osteopathic Association (AOA).
OK, so how do I locate a sports medicine doctor?
To locate a primary care sports medicine doctor in your area, you should contact the American Osteopathic Academy of Sports Medicine.
American Osteopathic Academy of Sports Medicine (AOASM) 2424 American Lane Madison, WI 53704 Phone: (608) 443-2477 Fax: (608) 443-2474 or (608) 443-2478 Executive Director: Susan Rees email: info@aoasm.org
Any final words of advice?
Remember, anyone who claims to be a sports medicine doctor may or may not have done additional training in sports medicine. This does not necessarily mean they are incapable of treating your condition, because many doctors become proficient on their own. However, if you don't have a good recommendation to go by, you may want to locate a certified sports medicine physician. Contacting one of the above organizations is a good start. When you call a doctor's office, you may also want to ask the following questions:
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Sports Medicine FAQ - American Osteopathic Academy of Sports ...