Podcast Summary: Managing Challenges as a Physician – Patient Interactions

Podcast: The AOFAS Orthopod-Cast
Episode Date: March 11, 2026
Panelists: Ben Jackson (Host), Joe Park, Dr. Khadakia, Pam, and others
Setting: Recorded live at the AOFAS annual meeting

Episode Overview

This episode tackles the evolving landscape of physician–patient interactions, with a particular focus on the impact of Name, Image, and Likeness (NIL) changes in collegiate athletics, the resulting medico-legal implications for doctors, and broader access and socioeconomic challenges in caring for patients. The panel shares real-world experiences, legal anxieties, ethical considerations, and the changing nature of physician roles. They also touch on the moral injury faced by physicians when unable to provide timely or optimal care due to external social and systemic pressures.

Key Discussion Points & Insights

1. NIL and Changing Dynamics in Athlete Care (00:33–16:49)

• Shifting Stakes for College Athletes

  • NIL rights have made college athletes more like professionals, increasing pressure to return to play quickly but with greater risk to future contracts or transfers.

  • Doctors are faced with patients who, despite being medically cleared, choose not to play to protect “value” (e.g., transfer prospects or contracts).

    “I’ve operated on patients who have immediately transferred once their surgery was done across the country. And that’s another puzzling thing. You don’t get the normal follow up as you’re accustomed to.” – Joe Park [01:27]

• Legal Risk and Liability

  • With college (and even high school) athletes now earning substantial sums, physicians face heightened legal exposure—sometimes in the tens of millions—if treatment is perceived as career-limiting.

    “Now they’re getting a million, $2 million, $500,000....I was in a case for high school. The numbers were in the $20 million range. High school. This is nonsense in my opinion.” – Dr. Khadakia [03:24]

  • The “burden is only on us,” with physicians often left to defend decisions against unhappy athletes and legal actions.

• Changing Decision-Making and Practices

  • Some surgeons now avoid official team roles due to these risks; others resort to co-scrubbing for legal documentation.

    “I have actually fundamentally…stepped down from Northwestern athletics for most of [my role]. Unless it’s really weird...It was a lot of extra liability. These are not amateurs anymore.” – Dr. Khadakia [08:35]

• Complexity in Medical Examinations of Transfers

  • Concerns about how honest documentation of old injuries can derail an athlete’s career and subject the physician to lawsuits from players denied contracts.

    “Now 12 other teams don’t want to pick them up. Now they don’t get their contract. Now they’re going to sue you for I don’t know what, because lawsuits are easy to do….” – Ben Jackson [07:32]

• How to Advise Return to Play

  • Shared decision-making is now crucial—balancing risk, athlete’s preferences, contract status, and future prospects.

    “If you were my son or daughter, I would not allow them to play on this. But you’re an adult...make this decision with the coaching staff.” – Joe Park [11:13]

• Most Likely to Take Risks

  • Ironically, high school athletes often push hardest to return, despite the most to lose from inadequate healing.

    “The funny thing is, who’s most likely to play through that? The high school kid.” – Panelist [15:38]

• Diminished Attractiveness of Sports Medicine

  • Panelists agree that working with athletes now brings far more liability and less glamour or reward.

    “The job has gotten dramatically less glamorous and dramatically more liability to it....You can be on the hook for $30 million. I can’t think of many other areas in life that you could have so little reward for so much liability.” – Ben Jackson [16:49, 18:19]

2. Ethics and Economics of Physician Compensation (18:19–21:47)

• Compensation vs. Risk Dilemma

  • Discussion on the mismatch between reimbursement and liability; suggestion (somewhat tongue-in-cheek) that surgeons deserve a cut of future athlete earnings for assuming career-defining risk.

    “I will do your surgery for 1% of all your future earnings...Why should you be liable for $20 million for a high school athlete, yet you get the one-time surgery fee?” – Ben Jackson [18:19]

  • Societal expectations are that physicians accept this responsibility as a moral imperative, rather than for financial gain.

    “Society has a problem, and our job…, was to help people. And yes, you make a good living, but your fundamental ethos is to help people. Agents’ fundamental ethos is to make money.” – Dr. Khadakia [19:28]

  • Highlighting physician burnout rooted in undervaluation and increasing administrative burdens.

    “Our society…thinks they’re entitled to get the care…that contributes to…physician burnout. They didn’t pay me anything.” – Panelist [20:04]

3. Socioeconomic & Access-to-Care Challenges (22:28–27:58)

• Impact of Immigration Policy and Social Climate

  • “Pam” shares LA-based experiences caring for Hispanic and immigrant communities, where fear of deportation and racial profiling lead to missed appointments and delays in care.

    “I’ve had a higher cancellation rate, for sure, no show. And definitely seeing the results of that...patients not being able to come in because they’re fearing for their lives.” – Pam [22:37, 23:50]

• Systemic Disparities in Patient Outcomes

  • Only the most urgent cases make it to the OR, often after long delays; access to advanced surgical care is limited, especially among marginalized groups.

    “You got this other person that can’t get their basic Weber B ankle fracture fixed…When you see somebody with a six-week-old ankle fracture, you know they’re not going to have as good outcome as had they come to you a week after…” – Ben Jackson [26:16]

• Moral Injury for Physicians

  • Doctors feel powerless to address systemic issues, frustrated when forced to provide ultimately suboptimal care.

    “When you care about patients, you hate that when they don’t have as good outcome as what you wish they would have had.” – Ben Jackson [27:58]

Memorable Quotes & Notable Moments

• “The burden is only on us.” – Dr. Khadakia [04:46]
• “College athletes are a curious deal. They have potential for massive income. They don’t have any guarantees. And now they’re getting paid certain weird amounts of money…they’re in their own unique bucket.” – Dr. Khadakia [15:51]
• “The last thing we have as doctors is…the sense that we do things for the right reason. That goes right out the door.” – Dr. Khadakia [18:52]
• “Understand your liability so that you don’t get into trouble. And I will promise you nobody will come to your aid. So just be careful and know what you’re getting into.” – Dr. Khadakia [21:47]
• “We have all this capability…all these things that we can offer. But there is such a discrepancy of patient care and access to care.” – Pam [25:46]

Timestamps for Key Segments

• 00:33–07:12: NIL and its impact on athlete care & legal risk
• 07:12–13:56: Decision-making: clearing athletes for play, and the challenges of medical screenings for transfers
• 13:56–16:49: Professional vs. college vs. high school athlete paradigm, burnout, and shifting physician attitudes
• 18:19–21:47: Ethics of physician compensation and liability; physician burnout
• 22:28–27:58: Socioeconomic disparities, immigration fears, access barriers, and moral injury

Takeaways for Listeners

• Physician roles are changing rapidly—especially in high-profile, high-stakes sports medicine due to new NIL rules and legal risks.
• Doctors must balance patient autonomy, legal realities, and personal wellbeing—and be aware of the mounting liability in treating athletes.
• Caring for marginalized populations means facing external social, legal, and economic barriers, often leading to worse outcomes and greater moral distress for physicians.
• Healthcare professionals must be realistic about the rewards and risks of their practice environment and advocate for changes when possible, all while maintaining their core mission to care for patients—however and whenever they show up.