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Peter Ferrell
The Hockey Writers
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Panthers Medical Staff Need Second Opinion
For the second time in two seasons, the Florida Panthers are not doing the National Hockey League any favours as it seeks to rehabilitate its concussion management image (or, you know, even have an image in the first place).
Disclaimer
Before I begin, just let me say that neither I, nor anyone else at The Hockey Writers, pretend to have any medical training or insight, and can’t possibly know the actual details of any player’s health, concussed or otherwise. We are only presenting the facts available to us, along with the concept of neutral/third party medical opinions contributing to NHL concussion management.
Florida Panthers’ Pattern of Concussion Relapse
Now, on to the business at hand.
Colton Sceviour was sidelined for a fourth consecutive game Monday night, missing out on Florida’s 8-5 loss to the Tampa Bay Lightning. Sceviour has been suffering from an upper-body injury since Oct. 20.
Officially, anyway. The fact he left a game with a suspected concussion less than a week earlier piqued my interest: why was he returned to action after sitting out only one game? And is this second injury also a concussion, as CBS Sports implies?
This situation is eerily similar to the one which befell fellow Panther Aaron Ekblad last season: a player being medically cleared to play before either experiencing a recurrence of symptoms and or sustaining another, potentially related injury, suggesting that, perhaps, said player was not, in reality, fully recovered when he returned to the lineup.
Aaron Ekblad seems to be back fighting fit this season after a rough, injury-plagued 2016-17 campaign. (Amy Irvin / The Hockey Writers)
For Sceviour, the season just started, so what’s the rush? And in Ekblad’s case, the Panthers were so far out of the playoffs that the logical thing to do would have been to shut him down for the season.
Aaron Ekblad’s Concussion Management
I wrote at length last season about what I considered to be the mistreatment of Ekblad’s head and neck-related issues, after the Panthers inexplicably rushed the young defenseman back into action following his third concussion (or related injury) in just over a year. Unfortunately for Ekblad, the results were catastrophic.
Then-Cats head coach Tom Rowe later stated he regretted bringing Ekblad back so soon, saying, according to the Miami Herald, “That’s on me. The doctors cleared him, our medical staff cleared him but I had some reservations and I wish I stayed with my gut.”
One of Ekblad’s injuries last year was sustained at the World Cup of Hockey. The Olympics aren’t looking so bad now, eh NHL? (Eric Bolte / USA TODAY Sports)
Again, as with Sceviour, the question is: why was Ekblad cleared to play in the first place?
Colton Sceviour’s Concussion Management
Now we return to Colton Sceviour, whose injury troubles were the catalyst for this article.
After sustaining what certainly seemed to be a concussion Oct. 14 against the Pittsburgh Penguins (thanks, Patric Hornqvist), Sceviour was held out of the following game against the Philadelphia Flyers. He returned Oct. 20 against the Penguins (playing only 9:42) and then started against the Washington Capitals the next night, but left the game after only 3:40 of ice time.
A logical reading of the situation is that Sceviour returned to the lineup – meaning he was medically cleared – before he was, in actuality, fully recovered, and was either experiencing the recurrence of concussion-related symptoms or else sustained a secondary concussion.
Panthers Players Have Rights
The Collective Bargaining Agreement stipulates NHL players are entitled to seek an independent second opinion regarding their condition. However, former NHL goaltender Glenn Healy is on record as saying players attempting to do so have “often received grief from [their] clubs.”
Maybe Sceviour and Ekblad did not deem a second opinion necessary. After all, it’s only natural to assume a multimillion-dollar organisation would hire the most talented, best-informed medical professionals to protect and care for its multimillion-dollar assets.
Or, perhaps they were wary of pushback from the organisation – and maybe even their teammates.
It’s also possible they both got second opinions that we just didn’t hear about – opinions that concurred with those of the Panthers, thereby clearing them to play.
Whatever the case, it’s entirely possible that someone somewhere got it wrong. Remember what happened to Sidney Crosby? And no, not just the concussions:
NHL’s Medical Issues Magnified in Florida
A basic problem that many professional sports leagues, the NHL included, face is the idea of team doctors. The issue is evident in the name itself: “team” doctors. As in, the physicians caring for the players of NHL teams are employees of said teams.
To be clear: I am not, in any way, implying the Panthers’ medical staff have, in any way, been mistaken and or negligent in their treatment of Sceviour or Ekblad – or anyone else, for that matter. I am merely pointing out the potential for a conflict of interest, given that the doctors are paid by the teams, rather than, say, an insurance company or the National Hockey League Players’ Association.
The Panthers’ website lists Dr. David X. Cifu, brother of Doug Cifu (the team’s Vice Chairman, Partner and Alternate Governor), as the team’s Medical Consultant, which seems to be the top-ranking medical official in the organisation. So, the Panthers, already with the aforementioned potential for a conflict of interest, have the added layer of their head medical professional being the brother of a senior executive.
Again, nothing implied, but it’s not a good look.
Panthers Physician’s Difference of Opinion
There are also differing opinions within the medical community regarding the best treatment for concussions. Dr. Cifu’s medical opinions regarding the treatment of concussions (also known as traumatic brain injuries) seem to go against the general scientific consensus – and common sense, for that matter. Full video, with transcript, can be found here.
Thus, even if medical teams are practicing to the very best of their training and abilities, there clearly exist differing opinions in the medical community regarding the treatment of concussions. Dr. Cifu, who’s had a prestigious career at Virginia Commonwealth University and the United States Department of Veterans Affairs, certainly seems to be in the minority (though the speaker following Dr. Cifu did agree with him).
In Ekblad’s case, despite the unpredictability of concussion recovery we’ve seen time and again in the NHL, the Panthers had a prescribed timeline for his return, seemingly in line with Dr. Cifu’s medical opinion.
Related – War on Ice: The Chilling Truth of Enforcers, CTE & Fighting in the NHL
Panthers Players Primary Priority
Now, just because a medical professional holds non-conventional views does not mean they should be discredited. Quite the contrary; one might say the whole idea of science is to constantly hold conventional wisdom up to scrutiny to help society make the best, most informed decisions possible.
However, this is two Panthers players in two years that seem to have been cleared to return to duty far more quickly than conventional wisdom would suggest prudent, only to relapse shortly thereafter. An unfortunate coincidence? Perhaps, though it would be inlaid with the even more unfortunate coincidence of each players sustaining multiple, unconnected concussions in such short order.
Regardless, given that these are human beings with livelihoods and families, I feel the Panthers – and the NHL as a whole – need to look at the disadvantageous situation they’ve put their players in, and ensure they are doing all they can to secure the players’ long-term well-being.
Eric Lindros is one of many players to have had a promising career cut short by concussions – and their mismanagement. (Steve Babineau / Allsport)
Seeking a Second Opinion on Panthers’ Concussions
Ice hockey is a dangerous game. People carrying sticks and wearing full, often rock-hard body armour whiz ‘round an enclosed sheet of ice on razorblades, crashing into each other and trying to swat a chunk of solid rubber into a metal four-by-six.
The best we can do is find ways to make the game safer (which the NHL seems utterly disinterested in doing) and to ensure that we, as a society, are putting our best foot forward to mitigate and rehabilitate any injuries that do occur.
You can’t put the entirety of that responsibility on the players. Athletes are competitive by nature; in fact, if they don’t want to play every single game, they should probably find a new profession. That being said, athletes (the vast majority, anyway) are also not medical professionals, and should not be expected to behave as such – even with regards to their own bodies.
Judging by the recent results out of the Florida Panthers’ sick bay, I don’t think it’s unreasonable to suggest their plan for the treatment of concussions warrants a second opinion.
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