Sports medicine was once the province of a few physicians serving professional sports teams. It has spread as a specialty through the professionalization of college and high school athletics and through the popularization of high- performance athletics for personal fitness. The sports medicine physician must balance the issues of long-term health with short-term performance. This compromise is not new to sports medicine, but it has become controversial as questionable practices such as the use of steroids, local anesthetics, and various forms of doping have come to the attention of the public. Sports medicine poses substantial legal problems, particularly when it is practiced on children.

The team physician has a more ambiguous role than the sports medicine physician who treats individual athletes but has no involvement with organized sports teams. The team physician’s job has become more difficult as the notion of amateur athletics has been displaced by professionalism in all but name. College football is run as a farm club for professional teams. In large high schools, the coach who in the past might have been an ex-football player and taught in the school system has been replaced by highly specialized coaching staffs with trainers and big budgets. The responsibilities of the team doctor have changed from being available to treat injuries at the weekly game to an ongoing responsibility for the development and care of the athletes. These coaches train their players for professional-style play and expect team physicians to minister to them as if they were professional athletes. This situation creates a conflict of interest for the physician when the athletes are legally and physiologically children.