James Andrews, MD, founder of the Andrews Institute of Orthopaedics & Sports Medicine in Gulf Breeze, Fla., has trained some 300 sports medicine fellows during his career and taken care of professional athletes the world over, the likes of Brett Farve, Michael Jordan and Roger Clemens. He is the team physician for the Washington Redskins and Tampa Bay Rays and past president of the American Orthopaedic Society for Sports Medicine. He continues to serve on the board of directors for AOSSM and was recently appointed to the medical advisory board for IntelliCell BioSciences, along with other partners in his practice. He is also the medical director for Auburn University interscholastic sports and senior orthopedist for the University of Alabama sports teams.
Here, Dr. Andrews discusses the most important elements for building a successful career in sports medicine.
1. Practice humility and compassion as the firsts step toward greatness. There are a number of qualities sports medicine physicians must adopt to build a foundation for success, with the most important being humility. "If you take too much personal credit for your successes and dwell on them, you are going to have a problem," says Dr. Andrews. "You aren't going to be good at medicine without humility."
In some cases, physicians have gained a reputation for being arrogant and under-serving their patients. Showing humility and compassion rejects this reputation and fosters respect and credibility.
"Humility and compassion are very important parts of your success," says Dr. Andrews. "You've got to show compassion for people who are injured. Remember that patients are always right, even if they aren't in the best frame of mind after dealing with a knee injury or chronic illness. You have to understand that situation and be compassionate for them; otherwise, they'll think you are arrogant."
2. Consider sports medicine a profession first, a business second. Taking care of patients and returning them to play should be the number one priority of sports medicine physicians; the economics of the business should be a distant second, according to Dr. Andrews.
"Orthopaedic sports medicine is a people's business and in general deals with taking care of people with an active lifestyle of all ages," he says. "You've got to have a positive relationship with your patients. To think of the business of medicine as the cornerstone of your practice is wrong. For me, medicine is more of a profession than a business."
The definition of sports medicine is taking care of active, athletically-engaged individuals of all ages and experience levels. Taking good care of patients could mean the difference between being healthy and active or abandoning activity for a sedentary lifestyle. While it's important to keep your sports medicine practice open, accruing high profitability should not be the physician's number one priority.
"I've never treated practicing sport medicine as a business and I've never tried to figure out the financial aspects of medicine," says Dr. Andrews. "Economics is important, but if you let that economic aspect overshadow doing what is best for your patients, you'll never be successful in any type of medicine. That's the key to how I would think about our profession."
3. Focus on public relations resources on research and education, not marketing. Everybody wants to build an outstanding reputation among their patients and colleagues, which means investing in public relations. However, instead of spending money on billboards or television advertisements, physicians at the Andrews Institute concentrate on research and education in orthopedics and sports medicine.
"You can't be criticized when you are spending your extra time developing young sports medicine physicians in a fellowship program," says Dr. Andrews. "I've spent my time over the past 40 years building a foundation in research and education to give young physicians an opportunity to excel in sports medicine. If you are involved in research and education, it will make you and others better. Research and education gives back to the field, which is key to our success at Andrews Institute."
In addition to training fellows, Dr. Andrews gives presentations at national society meetings. As for marketing, Dr. Andrews depends on the word-of mouth technique, gathering referrals and reputation from one patient to another.
"We developed our practice patient-to-patient, athlete-to-athlete," he says. "Let someone else tell the good story for you and you won't be tempted to toot your own horn."
4. Make yourself always available. Availability is important because if you don't make yourself available to take care of patients, they will go somewhere else. This may mean working long hours — even on weekends — and adding extra patients into an already packed schedule, but it will build the foundation for a strong and well-respected practice.
"You can't tell patients you don't have time to see them or try to schedule them two months in the future," says Dr. Andrews. "You have to be available in sports medicine when things happen. You have to make time to take care of patients in an orderly and reasonable period of time — that's very important to your success."
As the practice grows, it becomes harder to fit everybody in. However, seeing patients in a timely fashion is still important, regardless of how successful you are. "You can never become too busy to see patients," says Dr. Andrews. "When I get a call about professional athletes or college athletes who get hurt on the weekends, I have to be available to see them the next day."
5. Build strong communication skills and strategies. When sports medicine practices fail, it's often because there is a lack of availability and communication for the athlete's treatment. Within the line of communication, Dr. Andrews says the number one priority is the player, followed by the player's parents. Once the players and their parents are updated, communication with the team coaches, management and ownership are required.
"You have to be able to communicate with your patients and those around you in sports medicine," says Dr. Andrews. "Especially important is communication with the athlete's parents. If the athlete's mother isn't happy, nobody is happy — that goes all the way up the professional ranks. You have to contact the athlete's parents and make sure to communicate with them; that's very important."
In addition to communicating with the players' parents and coaches, talking with their agents also becomes important in professional sports. "The further up the ladder an athlete goes, the more communication you have to consider," says Dr. Andrews.
6. Think positively throughout your career. Physicians are bombarded with negative situations in their practices, and negative thoughts can easily overtake them. Negativity is a hindrance to success in the medical field and sports medicine physicians must find a method for overcoming this stress. Dr. Andrews recommends physicians have a positive to negative thought ratio of at least 5-1, preferably 10-1.
"People that have positive thoughts are much more successful than those who have negative thoughts," says Dr. Andrews. "It's easy for physicians to slip into the negative category. Focus on positive thoughts and goals for your life and practice instead."
7. Exhibit confidence and moral character in all activities. Confidence is a key quality in medical professionals, especially for sports medicine physicians who work with athletes every day. Athletes are often very confident people and appreciate confidence in others, including their physicians.
"Physicians should exhibit confidence in their activities, thought processes and recommendations to patients," says Dr. Andrews. "You should be confident in your diagnosis and treatment recommendations. If you are wishy-washy to patients, particularly athletes, they recognize that. You still have to be realistic with them, but always display confidence."
Along with confidence, physicians must exude a strong moral and ethical character. "In medical ethics, if you do what is right for your patient, your ethics won't be questioned," says Dr. Andrews. "If you have a question about whether something is right for your patients, it probably isn't. If you don't have good ethics, sooner or later people will catch up with you and you will be unsuccessful in your medical career."
8. Be patient and persistent with career development. Orthopedic surgeons and sports medicine specialists are unique; only the top applicants are selected for medical schools and orthopedic residencies only accept the very best students out of medical school to complete their programs. Sports medicine fellowships are even more exclusive, which means anyone completing a sports medicine fellowship and earning certification is an unusually bright and highly motivated individual. However, once physicians begin their practice, they must be patient and build a foundation of good medicine before rising to the top of the field.
"Sometimes, if young physicians are too aggressive in moving up the ladder, they can run into trouble," says Dr. Andrews. "They have to build their reputation gradually, demonstrating quality in sports medicine. You can't expect to come out of training and take a spot at the top of the field. You have to continue to listen and learn throughout your career. The man who says he knows everything is headed for disaster, and young physicians must be careful not be a know-it-all because that leads to self-made controversy."
Dr. Andrews says that today's young physicians must have completed a sports medicine fellowship and a certificate of added qualification to become a leader in the field, especially if they are planning on serving with a professional athletic team. In addition to training, involvement with the American Orthopaedic Society of Sports Medicine (AOSSM) and other professional organizations becomes a crucial aspect of career development. Begin by volunteering for committees and taking your place at the bottom of the ladder and be willing to work your way up to the leadership positions.
"It's those who are qualified who will be able to get involved and move up the ladder," says Dr. Andrews. "It takes 30-40 years to reach the elite levels of these societies. Young physicians have to realize it takes a lot of persistence — which is another word for success — but you must earn it. Becoming involved in AOSSM is crucial for young physicians to enter into the elite world of sports medicine."
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