From yesterday’s WSJ, a look into how player health records are managed in the contractual sphere Excerpt, followed by link:
I would categorize the things that we see in these players’ contract physicals into two general categories,” said Neal Elattrache, a leading orthopedic surgeon who is the physician for the Los Angeles Dodgers. “One is trying to assess the risk for injuries that might be the same percentage risk as it will be six years from now—like a pitchers’ elbow. The other, which is a lot trickier, is if a player has had an injury or condition that is gradually degenerative over time.”
Once a team’s medical staff generates an assessment, it’s up to front offices and ownership to determine whether they’re willing to take a gamble on the player’s durability. In the case of a smaller one-year deal, the risk of injury may be easier to swallow. By the time a player reaches six years of major-league service time and is eligible to become a free agent, they’ll have an extensive medical history for a team to review.
Major League Baseball keeps every player’s electronic medical records in a central database, which the league established in 2010. Those records include things like imaging and surgery histories, along with notes from athletic trainers, who file notes on players at the end of each day, painting a more nuanced picture of a player’s health history.
The records are accessible via player-specific codes, which MLB sends to the players’ union to distribute to agents. The agents in turn can then choose which teams to share the player’s codes with—usually just those who may have serious interest in the player—so an initial medical history review can commence.
Once contract terms are agreed to, a player then undergoes a battery of tests. That may include imaging—likely in an MRI tube—along with an orthopedic exam. Players also meet with an internist and take blood and urine tests. Some physicals may involve athletic testing, assessing things like acceleration and balance.
“I come up with a risk assessment,” Conte says. “Every team does this differently. Some people do green, yellow and red. Others do low, moderate, high. I do a nine-scale—one through three is low-risk, four through six is moderate, and seven through nine is high.”
An understanding of current injury treatments and timelines is crucial for a physician to make assessments. Elattrache says he tells teams that if a player does suffer a specific injury, the current interventions and rehab processes might keep him off the field for a certain amount of time. For pitcher elbows, these processes are fairly standard now. Shoulder issues currently have less consistent outcomes.
The process of the testing can typically take one to two days. In many cases, teams come to a determination within another day or two on whether the player’s medicals have met their standards.
If a team determines that a player’s risk of injury is higher than initially expected from the preliminary medical history review—or higher than they can tolerate under the agreed-upon terms—it can re-engage the player and his agent to determine possible solutions. In some cases, especially when a player may not have a robust free agent market, the terms of the deal may be reduced or restructured.
A team can insulate itself from risk by adding contingencies to a contract—things like club options that would allow the team to get out of the deal with a negotiated buyout fee. Contract language could also be highly specific. Former Mets ace Jacob deGrom signed a five-year guaranteed contract with the Texas Rangers in early December, but the agreement includes a conditional sixth year that is contingent on innings pitched, performance, and health.
A player has the option to agree to renegotiate terms with a team after a physical review, or they can take their services back to the open market. In the case of Correa, his status as a top free agent allowed him to explore the market after failing his physicals with the Giants and Mets.