A statistical study of physician care patterns in high school football injuries

This study examines the specialty background, relative activity, role, and cost of care among physicians treating high school football injuries in six western states. There were 1,000 injuries (in 1,000 players) in the 1980 football season. Among the players, 30.7 and 17.9% were treated solely by general practitioners and emergency room physicians, respectively. Orthopedic surgeons exclusively managed 17.1% of players, and 6.8% were seen initially by the emergency room physician and referred to an orthopedic surgeon. Osteopaths solely treated 6.4% of players. Chiropractic was the exclusive care for 6.4%. Four and nine-tenths per cent of players were seen initially by general practitioners and referred to an orthopedic surgeon. Emergency room physicians referred 3% of their injured high school football players to general practitioners. The remaining 6.8% of players were cared for by dentists, pediatricians, general surgeons, naturopaths, neurosurgeons, urologists, otolaryngologists, and ophthalmologists. General practitioners referred 14% of their patients, and emergency room physicians referred 73.6% of their patients. The most common referral was to an orthopedic surgeon. Two hundred ninety-eight players ultimately received care from an orthopedist, including 82% of all patients with fractures. For patients with the same diagnosis, costs for care by orthopedic surgeons were 54% higher than the fees charged by a general practitioner.