The New Orleans Saints’ firing of two team orthopedists is unprecedented in its timing, extremely unusual on multiple levels and raises numerous questions.

An ESPN report on Wednesday said the doctors were fired after a misdiagnosis of cornerback Delvin Breaux’s leg injury. After Breaux was diagnosed with a bone contusion two weeks ago, a second X-ray by a different doctor revealed a fracture in his fibula. Breaux reportedly needs surgery and will miss four to six weeks.

Saints players have reportedly had issues with the team’s medical staff for a lengthy period.

The #Saints doctors have been a source of frustration for players for years. This is only the latest example. https://t.co/8ERqNPO6Lh — Ian Rapoport (@RapSheet) August 16, 2017


There are likely many layers to this story that the media and public doesn’t know – and never will.

This might be the most unusual set of circumstances in NFL team physician history.

Changes to medical staffs happen from time to time. But they almost universally occur in the offseason. And these position changes are usually handled internally and not played out in a public forum. Medical changes are usually announced through a carefully crafted press release. I do not recall a time where a team physician was called out in a leaked media report.

Further, while doctors must absolutely be held accountable, the acts detailed here do not seem to rise to a level as egregious as what the public narrative has become. Perhaps a pattern of behavior warrants the transition, but the suddenness and timing of the change is odd.


Moreover, it is highly problematic to remove a team doctor without a replacement lined up. The Saints have acknowledged they will commence a search for a new physician. If a kicker misses one too many field goals, he may get cut – but not before a new one is brought in.

The only other time I recalled a team not having a head team physician in place was when the Browns switched their medical sponsorship in 2014, but that was in the offseason.

Either Saints head coach Sean Payton made a rash decision or he felt he had no choice. Because of this quick change, the team is now stuck finding an orthopedist on short notice – one willing and able to clear his schedule.

A team doctor needs to be available daily during training camp. Even during the season, the doctor’s patient schedule must be altered.


And he or she cannot book surgeries on a day the team is travelling and must alter his/her daily routine to accommodate the team’s needs. Good orthopedic Surgeons are generally booked months in advance, just as the best restaurants are full and cannot accommodate large parties on short notice.

It takes a lot of finagling to fit in running a practice and working what amounts to a full-time job as the orthopedist for an NFL team.

The new doctor also will need time to get familiar with players and their medical histories. It takes even the best doctors time to acclimate to the requirements of being a physician for an NFL team.

With the Saints medical sponsorship by Ochsner, the new orthopedist will likely be affiliated with that health system, which is same system with which the fired doctors are affiliated. While NFL rules prohibit the direct “selling” of the team doctor position, it has become the norm for the medical sponsor and team physician to be aligned.


As for what transpired with the terminated orthopedists, it certainly is the team physician’s job to be diligent and follow up with repeat imaging. But this does not seem to be a case of gross incompetence (missing an obvious fracture where the bones aren’t aligned).

Based on reports, Breaux’s fracture seems to be a stress fracture at the end of a plate he had inserted in a surgery last year.

While the Saints doctors absolutely should have seen the fracture on a repeat X-ray, any narrative that they missed a fracture on the initial X-ray may be incorrect. Stress-related fractures are often not obvious initially and often need repeat imaging.

This is not meant as an unequivocal defense of the fired orthopedists, but it must be pointed out that doctors are essentially prohibited from defending themselves due to HIPAA patient privacy laws. We have not heard publicly from either doctor yet and are unlikely to.


Payton told ESPN the Saints would work with Chargers doctors this week while the team is in Los Angeles for joint practices and Sunday’s preseason game.

Although the primary care physicians for the Saints remain the same and the team has a good training staff, this is not a best-case scenario by any stretch. Not only are Chargers players the chief concern of Chargers doctors, but those doctors are just getting to know their own team since they were hired a month ago after the announcement of the Chargers medical sponsorship. Further, how are the home team doctors going to work both sidelines during the game?

This is not to say the Chargers doctors are not capable of handling the workload. But covering an NFL training cap is demanding for any doctor, and their job is made more difficult with it being their first official NFL season.

Finally, in this era of enhanced emphasis on health and safety in the NFL, this move begs the question of whether it is prudent to allow a head coach to fire/hire the team doctors. Does this set up the potential to put undo pressure on the team doctor to get players back on the field? At the collegiate level, there has been a movement to not have the medical staff/athletic trainers report directly to the head coach for this reason.


The Saints are in a highly unusual situation, and we should all hope that it is solved soon and satisfactorily for the sake of the players.