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Leading Tommy John surgeon defends procedures for MLB players during coronavirus crisis

Jack Baer
Writer

As the coronavirus pandemic continues to rage in the United States and around the world, many are seeing the inequalities of the modern American healthcare system laid bare.

[ Coronavirus: How the sports world is responding to the pandemic ]

Thanks to private doctors and other services, the rich and famous have had relatively little trouble obtaining coronavirus tests and treatment, even as hospitals run short on tests, supplies, beds and staff. That outrage reached the sports world when it was reported the Utah Jazz required 60 percent of the state of Oklahoma’s daily testing capacity following Rudy Gobert’s positive test.

Those concerns have re-emerged as multiple Major League Baseball players undergo Tommy John surgery while the season is shut down, even as the surgeon general advises against elective surgeries.

Among the baseball players to require Tommy John surgery amid the MLB season shutdown are the Boston Red Sox’s Chris Sale, the San Francisco Giants’ Tyler Beede and, as of Tuesday, the New York Mets’ Noah Syndergaard.

One of the industry’s leading Tommy John surgeons is defending those procedures.

Dr. Neal ElAttrache defends Tommy John surgeries amid coronavirus crisis

In an interview with the San Francisco Chronicle’s Henry Schulman, Dr. Neal ElAttrache — a Los Angeles-based surgeon who performs Tommy John surgery and other procedures for several teams — said that such surgeries are too important to players’ livelihoods to be considered elective.

From the Chronicle:

“People need to be a little more thoughtful how they judge Tyler Beede or the Giants for trying to take care of him,” Dr. Neal ElAttrache said by phone from Los Angeles, where he is based.

“I know that I’m going to get criticized for taking care of these kinds of guys, but it’s essential to their livelihoods,” ElAttrache said. “If you have somebody’s career at stake and they lose two seasons instead of one, I would say that is not a non-essential or unimportant elective procedure.”

Tommy John surgery typically requires at least a year and sometimes a year and a half of recovery and rehab before players can return to the mound, meaning that players receiving the surgery now as opposed to the end of the summer could possibly return in time for a decent amount of the 2021 season.

Obviously, missing an entire season would be costly for both the player and his team, but likely not as debilitating an experience as some have experienced in the coronavirus crisis.

ElAttrache insisted that his clinic isn’t picking just any players to go into the operating room:

“We’re trying to select players so we don’t overtax the system,” ElAttrache said. “We have to have some criteria. We don’t want it to be arbitrary. We want the public to trust what we’re doing. If we didn’t have some criteria for selecting patients, we easily could be accused of bias for non-medical reasons and lose the public trust.”

The coronavirus shutdown hasn't stopped players like Chris Sale from needing Tommy John surgery. (AP Photo/Elise Amendola)

ElAttrache estimated that the Kerlan-Jobe Institute, where he works, has trimmed Tommy John surgeries by 90 percent, with all potential surgeries approved by an internal panel.

He also insisted that socioeconomic factors don’t affect the decision-making, only if someone’s livelihood is at risk if surgery is not performed:

“I don’t know any conscientious medical professional who looks at patients and makes judgments based on socioeconomic factors. Whether it’s a kid losing a scholarship, or a man who has to work (his arms) overhead because he has his own air-conditioning business, or a player making money on a good contract, if somebody’s livelihood is at stake, I’m blind to the name of the companies they work for.”

The surgeries in question are performed in private clinics, not the hospitals that are getting slammed with coronavirus patients right now. However, there is a question of whether those clinics should be using masks or ventilators during the pandemic over such hospitals.

ElAttrache saying that his institute talks to hospitals and public health officials daily, and will eliminated all orthopedic surgeries if needed for the public good.

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