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Nick Nelson
09-02-2012, 08:50 PM
You can view the page at http://www.twinsdaily.com/content.php?999-Outrage-Over-Medical-Staff-is-Overblown

J-Dog Dungan
09-02-2012, 09:10 PM
Well said, sir!

twinswon1991
09-02-2012, 09:10 PM
I respectfully disagree. The med staff was so bad that TR singled them out as a major area that needed improvement when he took the job. Since then, Baker, Pavano, and several minor leaguers have been harmed or ruined due to misdiagnosis.

The deal with Span and others is Ryan's inability to understand the DL rule which is something that won't improve until he is replaced.

Highabove
09-02-2012, 09:31 PM
It's the continuing pattern which is the cause for concern.
Nick, are you in the Medical Profession ?
If so, I will give more weight to your comments.

Mave
09-02-2012, 09:51 PM
I knew I would agree with the content of this article from simply by reading the title alone. I agree with both of your 'facts' listed above, and I know that other conversations on this site have cited other reasons why it is so hard for a medical staff to get it right 100% of the time. The past two years have been tough as a fan, with a significant amount of payroll and production sidelined for extended amounts of time.

I agree that when businesses are dealing with employees as expensive as professional athletes, that they will employ the best in the medical profession to ensure their investments are taken care of. It has simply been hard to watch a large portion of our productivity and payroll sidelined, especially when these are still young men who were coming off productive years on successful teams-- and we as a fan base were looking forward to years of success with a healthy, productive ans successful core.

Nonetheless, no two human bodies are alike, and not even the best of medical staff can be completely prepared to deal with the consequences of how demanding the game can be on even the fittest of athletes. The given track record of success, as mentioned above and then the contrast of the past two years has been tough. But how much of that is the ebb and flow of the game? How much of that is truly a reflection of the medical staff?

one_eyed_jack
09-02-2012, 09:57 PM
It's the continuing pattern which is the cause for concern.
Nick, are you in the Medical Profession ?
If so, I will give more weight to your comments.

----Did you actually read what Nick wrote?

To be clear, I'm not saying that the Twins' medical staff compares well to the rest of the league. They might even be among the worst. But I don't believe we have the evidence to make that assessment. Judging a doctor's performance isn't like judging a pitcher, or hitter, or manager, or GM. Each situation is unique and there are lot more factors in play than some would assume.

These comments need not come from a medical expert to be given weight.

I read him to be pointing out that the constant railing on the medical staff is coming from people who have neither the knowledge nor expertise to make educated evaluations of their performance, which unlike judging a player, is infinitely more complex than just making conclusions based on outcomes.

AMR
09-02-2012, 10:02 PM
Three Seasons ago, Rany Jazayerli wrote a screed about the Royals Medical staff (http://www.ranyontheroyals.com/2009/06/release-hounds.html). That staff was sacked in the offseason. I'd say the Twins' staff could have just as much complaint written about them, and I'd say it dates back to at least Rondell White's days with the team.

Mave
09-02-2012, 10:13 PM
I read him to be pointing out that the constant railing on the medical staff is coming from people who have neither the knowledge nor expertise to make educated evaluations of their performance, which unlike judging a player, is infinitely more complex than just making conclusions based on outcomes.

Word.

old nurse
09-02-2012, 10:15 PM
Every human body is a unique thing. If the medical profession were as straightforward as auto mechanics the complaints against the staff would have more validity. Are the players being honest with the medical staff? Are they doing what they are told to do? Is the medical staff equipped with all of the technology they need? Are the training/monitoring regimes up to date? There is a thing called differential diagnosis. Are the medical staff directed to go with the least severe differential first? All these questions have answers that are not available to the fan. When teams are winning, the fan doesn't care. When they lose, it becomes an excuse or a reason for the fan to blame someone for the losing.

Mave
09-02-2012, 10:45 PM
Thank you, old nurse, I think that was perfectly put. Taken directly from Dr. Jazayerli's article:

"I have long hesitated to wade into a discussion about the team’s medical staff, because as a physician myself I’m paranoid that someone might use my credentials inappropriately in this discussion.So let me be clear: in advocating for Swartz’s dismissal, I am not speaking as some sort of expert witness. I do not have access to any of the players’ medical records, and am not basing my opinion on some sort of medical expertise. I am arguing as a fan, and using the evidence that is available to all fans – the results on the field."

After that, I felt a little uneasy as I continued reading the rest of that article, especially reading about Mike Aviles because of the point you raised above-- are the players being honest with the medical staff? This was a young man fresh off of a 4th place finish on the ROY ballot and 5 pretty darn respectable years in the Royal's farm system. Dr. J continues, "Mike Aviles, after hitting .325 as a rookie last year, hits just .194 with one homer in his first 32 games this season, before finally coming clean on May 14th and admitting that his forearm was bothering him."

I don't know, the article just didn't sit well with me (for what it's worth). And I think that the blame on the Twins medical staff is, as mentioned above, a reactionary excuse to poor performance on the field and the production/payroll sitting on the shelf.

OldManWinter
09-02-2012, 11:34 PM
People jump to conclusions over a whole lot of things we have no way of knowing. Without all of that missing information any conlusion we make is inaccurate.

I have had three rotator cuff surgeries, two in the last 18 months. The oldest of the last two has not healed to allow a full range of motion despite best efforts of surgeon and therapist.

They will not heal evenly because they are all different. No one can predict or guarantee any result. It is not an exact science, the result will vary.

We do not have enough information to make educated guesses about their competence.

Updated Today at 09:31 PM by OldManWinter

Comment repeated from the blog.

nicksaviking
09-03-2012, 12:26 AM
Perhaps the medical staff has only made moderate mistakes, or perhaps just league average mistakes. If this is true, than Ryan, Gardenhire and anyone else making personel decisions based on the uncertain injuries are hangin the medical staff out to dry.

There is no rule that you need a firm diagnosis to place a player on the DL. Either the medical staff is not giving useful enough preliminary findings to the decision makers, or the decision makers are too indecisive to make a decision without a complete and accurate diagnosis.

Bottom line is, it didn't matter what was wrong with Span, SOMEONE should have had the foresight to have said, he's going on the DL seeing as he can't play now and this team is out of contention anyway.

NoCal
09-03-2012, 12:54 AM
A couple of observations.
- Span came back and played a couple of games; the last play he made was a long throw from centerfield to third base, catching a runner advancing on a fly ball. Could he have aggravated the earlier injury? If so, is it not logical that he might be deemed disabled at that point, more so than with the earlier, perhaps less severe, injury?
- These players make lots of money. Most probably have personal trainers and other members of their entourage who contribute to keeping the player on the field. And an agent, who most definitely has a say on whether the player goes on the disabled list or not. The medical staff does not have total authority on these decisions.
- Looking over the Collateral Damage section of Baseball Prospectus: the Twins injury rate is not exceptional, as measured by players on the disabled list. Excellent organizations like Washington and Texas have had far more injuries. That's life. And probably outside of our ability to evaluate.......

clutterheart
09-03-2012, 03:13 AM
In isolation, all incidents appear to be isolated. As a whole the pattern appears pretty damning for the medical staff.

I do not see other teams wait so long to put players on the DL. Quick google searches show me nothing of past players ripping the medical staff like Hardy and Osterbrook did. I so see many players who try and hide injuries, but other team's Dr's seem to figure it out.

Its a tough thing to measure because its so subjective, but in this case there does appear to be something fundamentally wrong with the way the team is diagnosing injuries, understanding the injury timeline and rehab.

Highabove
09-03-2012, 04:03 AM
Pavano, Baker, Hardey, Kubel, Neshek and Mauer, have all criticized the way their injury's were handled.
That should set off some alarm bells.

BD57
09-03-2012, 08:01 AM
I'm not so concerned about DL management. It's important, yes, but I can't see how it's really cost us the past two years.

My concern? We seem to have a lot of pitcher's arms blowing up & it seems we manage them all the same .... wait a while hoping to avoid surgery, doesn't work & now our guy's out for two years.

Obviously, surgery's a big deal. Obviously, we'd like to avoid it. BUT ... if there was a decent chance of avoiding surgery, wouldn't we be somewhere closer to 50/50 on "turns out surgery wasn't necessary"?

JB_Iowa
09-03-2012, 08:18 AM
I was not one of the people screaming about the medical staff last week -- as I recall I made some comment about "art" and "science"; however, the medical issues and DL use are puzzling to me.

BUT more than that, I'm concerned that even in what will be another 90+ loss season, fault FOR ANYTHING doesn't seem to get assigned. Terry Ryan makes the token "I accept responsibility" statement -- but what does that mean? It looks like this organization just rolls merrily along.

We'll see at the end of the season but for now, all I see is stagnation. And that is not a good harbinger for next season.

savvyspy
09-03-2012, 08:44 AM
I disagree. Scouting is an in exact science too yet the Twins are worse at it than almost every team. Pitching is an Inexact science yet the Twins are historically bad. This medical staff as botched almost every arm injury at every level of the organization. You DO NOT see this in other organizations. To chalk up continued failure of this team to address injuries and misuse of the DL process to basically chance makes no sense.

Don't Feed the Greed Guy
09-03-2012, 08:49 AM
Hey all,

I am hesitant to weigh in on medical matters. File it under the old axiom: "He who is his own doctor has a fool for a patient." Two things might sway my argument toward changes in the medical staff--and they may be the only factors that might steer Twins managment too:

1) Concern from the medical/sports medicine community, like Dr. Jazayerli's assessment of the Kansas City situation (see above).

2) Documented concern from present/former players. "Highabove" writes [QUOTE][/
Pavano, Baker, Hardey, Kubel and Mauer, have all criticized the way their injury's were handled.
That should set off some alarm bells.
QUOTE]
There needs to be some documentation/confirmation here, but those are the two points that would get my attention: 1) documented concern from the medical/sports medincine community, and 2) documented concern from present and former players.

Until then, medical diagnosis is a rather complex matter, especially when players are funtioning under a whole host of countervailing influences, such as protecting their playing time, long-term value, and their competitive desire to be on the field every day. How do you sort all that out from the bleachers? It's one thing to be a Monday Morning Quarterback, I don't want to be a Monday Morning Quack.

Let's see what happens this offseason. My hunch is that there will be some turnover in the training room.

Enjoy the Labor Day!

one_eyed_jack
09-03-2012, 09:23 AM
It would be interesting to see some actual quotes from these players. Were they openly critical about the medical staff? Or were they just expressing frustration about not being able to get back on the field sooner, which is being interpreted as a critique of the medical staff?

Either way, I don't know that it conclusively proves anything. The players are the recipients of the treatment, so they know a lot more that anyone here about what the medical staff actually does. But they don't have the expertise, so even if they are critical of the medical staff, it doesn't mean those criticisms are valid. Players have different goals than doctors, so some tension there is inevitable.

stringer bell
09-03-2012, 09:27 AM
I think it is impossible for laymen to judge what the doctors are doing. What seems to be beyond doubt is that the players, the team and the medical staff are not all on the same page. The players want to protect their careers, first and foremost, but they also want to play. They don't report small injuries and aches and pains because they don't want to get benched and they don't want to be considered malingerers. The most common scenario is an injury goes unreported until the player's performance suffers. The team wants their valuable assets to perform, but they want them long term. The medical staff wants to do what is right for the player, but they are employed by the team.


The three components need to communicate and get on the same page.

Fire Dan Gladden
09-03-2012, 09:56 AM
The same people that are leaping to conclusions about the medical staff are leaping to conclusions about how these situations are handled on other teams. Nobody here can tell me how the Mets handle theirs or the Mariners or virtually any other team. Until somebody comes up with an exhaustive study on what is reported, whether or not they end up on the DL, and follow up, the "it doesn;t happen anywhere else" argment needs to stop.

I too am concerned about how the DL is used, but considering the team has had a huge rash of injuries and DL usage over the last 2+ years, with lttle in the way of help from the minors, I can understand their trepidation.

Also, players can can be as much to blame here as the doctors. If they aren'y up front about the injury, or the severety, it can be harder to diagnose.

Finally, all the players complaining about the Twins med staff are ex-players, except for Pavano, who will not pitch another game for this team. Could easily be sour grapes. Easy to blame somebody who will not respond in the public environment.

twinswon1991
09-03-2012, 09:58 AM
I disagree. Scouting is an in exact science too yet the Twins are worse at it than almost every team. Pitching is an Inexact science yet the Twins are historically bad. This medical staff as botched almost every arm injury at every level of the organization. You DO NOT see this in other organizations. To chalk up continued failure of this team to address injuries and misuse of the DL process to basically chance makes no sense.

x100

Thrylos
09-03-2012, 10:39 AM
It's the continuing pattern which is the cause for concern.
Nick, are you in the Medical Profession ?
If so, I will give more weight to your comments.

----Did you actually read what Nick wrote?

To be clear, I'm not saying that the Twins' medical staff compares well to the rest of the league. They might even be among the worst. But I don't believe we have the evidence to make that assessment. Judging a doctor's performance isn't like judging a pitcher, or hitter, or manager, or GM. Each situation is unique and there are lot more factors in play than some would assume.

These comments need not come from a medical expert to be given weight.

I read him to be pointing out that the constant railing on the medical staff is coming from people who have neither the knowledge nor expertise to make educated evaluations of their performance, which unlike judging a player, is infinitely more complex than just making conclusions based on outcomes.

This sentence is actually pretty incorrect... Medical performance has always been judged based on outcomes, and in probably 2-3 years (some pilots are up and running now - google: ACO), most doctors will be "paid for performance" (where "performance" is mostly outcomes.)

As far as the Twins' situation goes, there are a lot of issues, including the doctors; but players and especially management have to take some of the blame for the waiting for Godot to go to the DL... Missdiagnosis, is another story

Nick Nelson
09-03-2012, 10:40 AM
My concern? We seem to have a lot of pitcher's arms blowing up & it seems we manage them all the same .... wait a while hoping to avoid surgery, doesn't work & now our guy's out for two years.

Obviously, surgery's a big deal. Obviously, we'd like to avoid it. BUT ... if there was a decent chance of avoiding surgery, wouldn't we be somewhere closer to 50/50 on "turns out surgery wasn't necessary"?

This is a common gripe, but I would suggest that it's less unusual than you think. Elbow injuries are extraordinarily common across the league and surgery is always considered a last resort. Most teams will prescribe rest & rehab before TJ, not just the Twins.


This medical staff as botched almost every arm injury at every level of the organization. You DO NOT see this in other organizations.

Please elaborate, keeping in mind the points mentioned above.

Brock Beauchamp
09-03-2012, 10:42 AM
I disagree. Scouting is an in exact science too yet the Twins are worse at it than almost every team. Pitching is an Inexact science yet the Twins are historically bad. This medical staff as botched almost every arm injury at every level of the organization. You DO NOT see this in other organizations. To chalk up continued failure of this team to address injuries and misuse of the DL process to basically chance makes no sense.

The Royals have sent a half dozen of their prospects to have TJS in the past year.

I don't believe the medical staff is doing a good job. That's not my point nor do I believe it to be Nick's point. It's easy to sit on your couch and "diagnose" maladies, especially when using the rearview mirror. It's even easier when you don't have the slightest clue what you're talking about (is anyone here qualified enough to make even the smallest statement about the medical treatment of athletes?).

No one is arguing that the medical staff is doing a good job. From the outside, it looks pretty bad to a layman. But remember that last word, layman.

People need to stop pretending that they have the slightest clue what is going on behind closed doors and they need to stop pretending that they have the medical knowledge to properly understand if someone is doing a bad job in the first place. I want to see the medical situation "fixed" as much as anyone but I'm also smart (and honest) enough to know that I don't have the slightest friggin' clue what I'm talking about.

JS
09-03-2012, 10:59 AM
[QUOTE=savvyspy;51481]
People need to stop pretending that they have the slightest clue what is going on behind closed doors and they need to stop pretending that they have the medical knowledge to properly understand if someone is doing a bad job in the first place. I want to see the medical situation "fixed" as much as anyone but I'm also smart (and honest) enough to know that I don't have the slightest friggin' clue what I'm talking about.

This completely sums up my issues with far too many commenters on this site. People come in to threads spitting vitriol about how much they screwed up this injury situation or this trade or this draft. For me, this goes all the way back to the Johan trade, since that was around when I started getting into Twins blogs (Gleeman). So many were up in arms because we didn't trade him for Ellsbury and Lester and whoever else, never minding the fact that the Red Sox never offered that package. Yes, the return on Johan was very underwhelming, but for all we know, it was the best offer available. Yes, the injury situation is very frustrating, but for all we know, we've been snakebit and any other team with the same players would've suffered the same fate.

Jim Crikket
09-03-2012, 11:12 AM
Overblown fan outrage? Say it ain't so, Rick.

Face it, the success of Twins Daily is, at least to a degree, the direct result of overblown outrage on the part of Twins fans these days about one issue or another.

JB_Iowa's comments are pretty on the money. I admit I have no clue whether medical/training staff are doing a good job in a tough situation or are botching things. Similarly, I don't know whether successive 90+ loss seasons are due to bad managing, coaching, scouting, general managing, overly frugal ownership or just poor player performances.

As a fan, I do know the Twins have been a bad team for too long and the results on the field, in much of the farm system, and in the training room have not been good. It also just seems far too simplistic to say it was all Bill Smith's fault and since he was reassigned, the Twins have installed a culture of accountability.

I'm not giving up on Terry Ryan because I don't think you can fix everything in one year. That said, although I'm not an expert on running a ballclub, I would like to see some evidence on the part of those in charge of the Twins (who certainly should be experts) that they are actively identifying areas that need improvement and are holding those in charge of those areas accountable.

SpiritofVodkaDave
09-03-2012, 11:24 AM
As an Orthopedic surgeon, I agree with this thread.

AMR
09-03-2012, 01:21 PM
the Twins have been a bad team for too long
It's been about 324 games now. We're spoiled.

Shane Wahl
09-03-2012, 01:30 PM
So what is exactly "overblown"? Is it too much to say that they appear to have made a number of very erroneous decisions the past two seasons? Maybe that isn't "outrage" but I think being frustrated is a pretty legitimate response to how medical issues have been dealt with.

Fire Dan Gladden
09-03-2012, 02:21 PM
Overblown fan outrage? Say it ain't so, Rick.

Face it, the success of Twins Daily is, at least to a degree, the direct result of overblown outrage on the part of Twins fans these days about one issue or another.

JB_Iowa's comments are pretty on the money. I admit I have no clue whether medical/training staff are doing a good job in a tough situation or are botching things. Similarly, I don't know whether successive 90+ loss seasons are due to bad managing, coaching, scouting, general managing, overly frugal ownership or just poor player performances.

As a fan, I do know the Twins have been a bad team for too long and the results on the field, in much of the farm system, and in the training room have not been good. It also just seems far too simplistic to say it was all Bill Smith's fault and since he was reassigned, the Twins have installed a culture of accountability.

I'm not giving up on Terry Ryan because I don't think you can fix everything in one year. That said, although I'm not an expert on running a ballclub, I would like to see some evidence on the part of those in charge of the Twins (who certainly should be experts) that they are actively identifying areas that need improvement and are holding those in charge of those areas accountable.

Can anybody tell me with any certaintity that there hasn't already been changes made and these things are still happening? Does anybody know if their has or hasn't been any changes to their medical staff in the last three years? I am not talking about team doctors, but the techs and specialists that are helping to make these decisions? It seems to me that, as usual, too many people are blasting the situation without any clear knowledge of what is going on.

SeanS7921
09-03-2012, 02:24 PM
This is correct, totally overblown.

Brock Beauchamp
09-03-2012, 02:43 PM
This completely sums up my issues with far too many commenters on this site. People come in to threads spitting vitriol about how much they screwed up this injury situation or this trade or this draft. For me, this goes all the way back to the Johan trade, since that was around when I started getting into Twins blogs (Gleeman). So many were up in arms because we didn't trade him for Ellsbury and Lester and whoever else, never minding the fact that the Red Sox never offered that package. Yes, the return on Johan was very underwhelming, but for all we know, it was the best offer available. Yes, the injury situation is very frustrating, but for all we know, we've been snakebit and any other team with the same players would've suffered the same fate.

At least with the Johan trade, you can fall back on the stats. I didn't like the players sent from the Mets in trade for Santana. I could back up my belief with graphs, charts, historical comparisons, etc. of each player. I could build a case, based on evidence, that it was not a good idea. I could compare that to the expected performance of Santana in 2008 and the comp picks the team would receive in return. I've watched baseball my entire life. I've spent the better part of my adult life pouring over the finer points of the game. I'm no baseball expert but I know something about the game.

On the other hand, I've only seen a half dozen episodes of House and I didn't even like the show much. I'm not a doctor. In all likelihood, nobody here is a doctor or even involved enough in the medical profession to do anything except speculate wildly over half-truths and diagnoses not seen by anyone outside of the medical staff and the organization. Hell, we don't even know if anybody has been fired for these perceived issues with the medical staff. We know virtually nothing. In short, there are a hell of a lot of people going off half-cocked about a situation they don't even understand. They don't have the slightest clue how the medical profession works, how the system operates, and whether the Twins are doing anything right or wrong. They see a bunch of injured players and start to lay blame. Are they wrong? I don't know. That's not my point... The point is that they don't know, either.

And in life, I've generally found that it's best to shut up when you don't know something.

As fans, we get frustrated. That's expected. We want to see changes when things go badly. That's expected. But there's a big difference between stating "the Twins medical staff is incompetent and needs to be fired, along with the front office" and "damn, I wish this team didn't spend so much time on the DL... what is the problem here?". One is raising an issue and trying to determine if the organization is at fault while the other comes off as heavy-handed and supremely arrogant considering the complexity and nuances of the human body and sports injuries. After all, people spend eight ****ing years getting a degree just to be allowed to diagnose a person. Why don't some of the people in this thread stop to consider that they look like fools when they don their Internet White Coat & Clipboard and pretend that they have the slightest friggin' clue what they're talking about?

jokin
09-03-2012, 03:01 PM
Overblown fan outrage? Say it ain't so, Rick.

"1) Face it, the success of Twins Daily is, at least to a degree, the direct result of overblown outrage on the part of Twins fans these days about one issue or another.

JB_Iowa's comments are pretty on the money. I admit I have no clue whether medical/training staff are doing a good job in a tough situation or are botching things. 2) Similarly, I don't know whether successive 90+ loss seasons are due to bad managing, coaching, scouting, general managing, overly frugal ownership or just poor player performances.

As a fan, I do know the Twins have been a bad team for too long and the results on the field, in much of the farm system, and in the training room have not been good. It also just seems far too simplistic to say it was all Bill Smith's fault and since he was reassigned, the Twins have installed a culture of accountability.

I'm not giving up on Terry Ryan because I don't think you can fix everything in one year. That said, although I'm not an expert on running a ballclub, I would like to see some evidence on the part of those in charge of the Twins (who certainly should be experts) that they are actively identifying areas that need improvement and are holding those in charge of those areas accountable.

Can anybody tell me with any certainty that there hasn't already been changes made and these things are still happening? Does anybody know if their has or hasn't been any changes to their medical staff in the last three years? I am not talking about team doctors, but the techs and specialists that are helping to make these decisions? 3) It seems to me that, as usual, too many people are blasting the situation without any clear knowledge of what is going on.

"1) Face it, the success of Twins Daily is, at least to a degree, the direct result of overblown outrage on the part of Twins fans these days about one issue or another."

I sense a staff meeting is in order, the topic: "How to avoid the 'Phil Mackey Disaffecting His Readers Effect' when writing articles"

"2) Similarly, I don't know whether successive 90+ loss seasons are due to bad managing, coaching, scouting, general managing, overly frugal ownership or just poor player performances. "

Let's see that's 6 possible answers, A/B/C/D/F/G....I'll vote for Box H- All of the Above.

"3) It seems to me that, as usual, too many people are blasting the situation......"

Despite a strong declarative opening statement from the new GM that the training/medical issues were a top priority, it seems demonstrably obvious to me by their repeated identical blunderings that the people in position to know and do something about the situation are first and foremost the prime suspects who don't, as of yet, have "any clear knowledge of what is going on."

And yet, to question the situation at this level of knowledge by the common layman is deemed "overblown outrage". Particularly after two seasons of: a peculiar happening, followed by an incidental instance, right after an odd occurence, after multiple players are physically unready to perform at a major league level on opening day, one seemingly innocuous injury after another, from the ridiculous- "bilateral leg weakness" (how was this 2011 epic catastrophe not even casually mentioned in the article?)- to the sublime- the repeatedly aggravating- Will he? Won't he? DL-Dance.

Silly and absurd characterization from the author about legitimate concerns that have yet to be properly addressed. This doesn't mean "fire everybody", but it sure as heck means complete evaluation and overhaul of procedures and the institution of accountability standards for everyone in the organization-, from the superstar on the field, to the top surgeon, to the masseuse on down to the towel boy.

Montecore
09-03-2012, 03:32 PM
The bad track record is evidence enough thar the medical staff needs to be shown the door. It's the same with Gardenhire. He doesn't deserve the benefit of the doubt.

TheLeviathan
09-03-2012, 04:05 PM
The only thing overblown is the thesis of this blog post. Nick did the same thing on the forum a few days ago and it's no less wrong now. This blog pins the argument into two absurd corners - either as staunch defenders of the organization out of medical ignorance or overly critical hyperventilators. Personally, I think the sane response to this issue is largely in-between.

This is a team that has been carrying 13 pitchers and one of the 12 position players (Butera) is a borderline major-leaguer with limited ability to contribute. When you spend 18 days with one of your other 11 position players in limbo - you're greatly impairing your team. Yes, this team is awful so the cost of this one position this year is minimal. However, bad practice is still bad practice no matter what the quality of the team is. Having a poor season is not an excuse to run your operation ineffectively. It's not "overblowing" anything to be critical of this.

I don't claim to know exactly what the problem is, but by comparison to other teams in the league it's clear the Twins are not utilizing the DL as effectively as others. It's also clear that their ability to assess and treat injuries is not at the same level as the other teams. There also appears to be an issue with player-medical staff communication. (Not laying fault either direction, probably both are guilty) I don't lump TJS into this because that could jsut be a fluke thing but it certainly adds to the frustrations, warranted or not. Again, I don't claim to know why the problems above are happening. That's for someone with more direct supervision of the team to assess and correct, but it's within my rights as a fan to question and be frustrated with what is now a two year trend.

It's not "overblowing" anything to be frustrated with the way the team is handling (or lack there of) injuries. It's one of many other things that the team needs to look at improving if they are going to return to contention.

joeboo_22
09-03-2012, 04:39 PM
Is it the medical staff or is it the front office and gardy? The medical staff I'm sure gives an honest opinion on most cases, though they have seemed to botch a few. Pavano's arm, Kubel's foot last year, Mauer's knee, etc. But over the last year I've seen way too many day-to-day's turn into weeks, and then months. Which makes me think its more the front office then the doctors.

Lets say its something like this.

Dr. well its not great, blah blah blah, could use surgery

TR: well can he pitch through the pain?

Dr. yeah, the damage is done, if he can pitch through the pain he'll be fine.

TR: so and so is day to day with arm problems

Guy tries to pitch through it, struggles, they try rehab, that doesn't work, and then 8-12 weeks later they decide on surgery. Well was the Dr. wrong?

So I think it might not be 100% medical staff, I think it might be more the front office. I don't care what the Dr. is telling me, if my centerfielder can't take BP 9 days after the injury I'm going to DL him.

Highabove
09-03-2012, 05:07 PM
It would be interesting to see some actual quotes from these players. Were they openly critical about the medical staff? Or were they just expressing frustration about not being able to get back on the field sooner, which is being interpreted as a critique of the medical staff?

Either way, I don't know that it conclusively proves anything. The players are the recipients of the treatment, so they know a lot more that anyone here about what the medical staff actually does. But they don't have the expertise, so even if they are critical of the medical staff, it doesn't mean those criticisms are valid. Players have different goals than doctors, so some tension there is inevitable.

Coments by Players who have had issues with their treatment have been documented in the Print and Broadcast Media
I will give you one regarding J.J. Hardy. Hardy speaking with 1500's Phil Mackey



"In spring training I started to feel it and got a little bit nervous, going, 'Oh (expletive), here we go again.' But the trainers worked on it, got rid of it in about a week, and I haven't dealt with it since." Hardy added that the treatment he received from Orioles' trainers was different than what had been tried in Minnesota, but he added, "I don't want to get into that too much and make people look bad, but yeah. It definitely was a little bit different."

Nick Nelson
09-03-2012, 05:21 PM
The only thing overblown is the thesis of this blog post. Nick did the same thing on the forum a few days ago and it's no less wrong now. This blog pins the argument into two absurd corners - either as staunch defenders of the organization out of medical ignorance or overly critical hyperventilators. Personally, I think the sane response to this issue is largely in-between.
Pretty sure my stance was directly in the middle of those two extremes. I'm not pinning anyone in any corner, I'm responding to the (very real) reaction I saw after the Span news dropped last week.


It's not "overblowing" anything to be frustrated with the way the team is handling (or lack there of) injuries. It's one of many other things that the team needs to look at improving if they are going to return to contention.
I'm not responding to the frustration over funky injury situations – that's well warranted. I'm frustrated with them too. What I'm responding to is the tendency to immediately blame the medical staff in every situation that pops up without considering the number of variables in play. I see people calling for the entire medical staff to be cleared out... do those people really believe that every single doctor, trainer and med tech under the organization's employ is incompetent? Seems pretty far-fetched. This is a complicated issue and the kind of blanket critiques often being thrown out there simply don't fit.

TheLeviathan
09-03-2012, 05:27 PM
This is a complicated issue and the kind of blanket critiques often being thrown out there simply don't fit.

I'm only seeing the "fire em all" rhetoric from a select few - you used this same "overblown" response to me the other day when I expressed frustration with the handling of the DL. Now apparently that is "well warranted" - I'm not sure you're even clear what you think is being overblown.

This article (and you can see it in the responses here) makes people think you're painting them into one of those corners.

BHtwins
09-03-2012, 05:36 PM
It hasnt been just 2 years of complaining, its really been 7 or 8 of grumbling and 5-6 of some pretty serious questioning.

Its not just Twins fanatics either. The Twins medical staff is pretty poorly respected among the agent community as well. Some players agents wont let a primary diagnosis come from them at all.

USAFChief
09-03-2012, 07:34 PM
I agree with BH above...this isn't a two year thing. The Twins handling of injuries in general, and the DL in particular, has been, at the least, questionable for years now. It cost them games when they were good, it's costing them games now. I don't think there can be any denying it. Whether the primary culprit is the medical staff, or the front office, I'm not sure, but to pretend this is "overblown" or worse, is poppycock.

You don't have to be an auto mechanic to see cars coming out of the same repair shop still broken, time after time, to decide there's a problem there. You don't have to be a doctor to look at the Twins mishandling of multiple injury situations, over a period of years, to decide there's a problem ​there.

Don't Feed the Greed Guy
09-03-2012, 08:32 PM
It hasnt been just 2 years of complaining, its really been 7 or 8 of grumbling and 5-6 of some pretty serious questioning.

Its not just Twins fanatics either. The Twins medical staff is pretty poorly respected among the agent community as well. Some players agents wont let a primary diagnosis come from them at all.

You need to document your claim.

1. Please get some quotes from "the agent community" to substantiate your claim. Also, to other posters:
2. Identify medical/sport medicine experts in order to confirm that the Twins medical staff have done something unethical or substandard.
3. Quote present/former Twins ballplayers who have gone on record stating that members of the Twins medical staff aren't doing their jobs.

The beauty of being a staff writer for the Stib or P.Press OR Twins Daily is working hard enough to validate your claims by confirming your sources. Otherwise, it's just a screed.

Or, in the days when I worked making pizza's at Davanni's (we ran 1 and a half hours per pizza delivery during game 7 of the 1987 World Series) the creed was "Care, Work Hard, Have Fun" At Cedar/Riverside, a Sharpie changed the sign to read "Have Funk!"

Under "work hard" I would encourage Twins Daily writers to do a little researcha and document your claims. Here's a helpful link http://www.easybib.com/

Let's keep each other honest.
Just sayin.

JB_Iowa
09-03-2012, 08:41 PM
Well, I won't pretend to document anything. But on the more than 2 years of complaining front, I remember absolutely screaming when Mr. Gardenhire kept putting Morneau in the line-up day after day in August/September 2009.

I posted over and over that there was something clearly wrong with him. I wasn't sure if it was physical or mental but I knew that there was a problem -- that it wasn't an ordinary slump.

And sure enough, after days and days and days of horrendous performance, they finally diagnosed the stress fracture in his back.

I have to assume that a lot of this is on Morneau but I still don't understand why that situation went on for as long as it did.

BHtwins
09-03-2012, 09:14 PM
I'm not a staff writer for Strib or PP. I'm a poster on a message board. Im not getting paid to waste time.

Pay me free lance rates and Ill find you at least 5 quotes from players over the last 18 months complaining about the Twins med staff blowing their diagnosis. The fact is I found them....but Im not citing them because I DONT CARE. You cite them if this matters to you.

I'll find paragraphs of written angst from Joe Mauers torn meniscus taking too long. Weeks of written screed about shutting Liriano down to "rest" before he ultimately got TJ. Throw in some beautiful quotes of the staff questioning Grant Balfour's toughness when he complained of forearm tightness that ultimately turned into TJ. All of those are over 5 years ago. There are dozens of examples of Twins players getting 2nd and 3rd opinions and you'd have a tough time finding any major Twins player that had anything ortho done in-house.

If you think things are great....then fantastic. I dont care, I stated my opinion, which in general is a hell of lot more interesting then regurgitated tripe.

Nick Nelson
09-03-2012, 10:35 PM
I'm only seeing the "fire em all" rhetoric from a select few - you used this same "overblown" response to me the other day when I expressed frustration with the handling of the DL. Now apparently that is "well warranted" - I'm not sure you're even clear what you think is being overblown.
Well what exactly were you angry about? If it's the medical staff, then this article is aimed at you. If it's something else, then what? Who exactly is to blame for this repetitive pattern? To me, it seems like a few evenly distributed iffy decisions mixed with a whole lot of bad luck. I'm guessing the medical staff deserves some blame, is it the main problem? How would you know?


I agree with BH above...this isn't a two year thing. The Twins handling of injuries in general, and the DL in particular, has been, at the least, questionable for years now.
By what standard? Who here follows another team closely enough to really make an accurate and objective baseline comparison? I really feel like a lot of people do not understand just how mysterious medicine is. Injuries and illnesses get misdiagnosed all the time, in sports and in life. Someone above cited the example of Morneau playing through an injury back in 2009... do you realize how common that is? Players hide injuries because they want to play. Managers defer too quickly because that's how clubhouses are run. Much of this stuff is just baseball, and has nothing to do with the team doctors.

It's a complicated issue and, to me, a low priority. I feel like we should be focused a lot more on figuring out how to put together a decent roster than complaining about an injured player tying up a meaningless roster spot for a last-place team. Injuries are just part of the game, and they're rarely a tidy affair.

Badsmerf
09-03-2012, 10:57 PM
People need to stop acting like medical professionals are Gods that know how to send a rocket to the moon. I don't really care how much experience they have since I've seen plenty of experienced idiots in my lifetime. These people aren't untouchable. None of us know exactly what is going on because we are all on the outside looking in, but it sure doesn't look very good to me. Nick, you can account bad luck or whatever you want, but that is clearly turning the other cheek. I'm not sure if the Twins need to fire people, but anyone that doesn't admit something has to be done is in denial. Everyone should be kept to standard and there has been too many situations that leave questions unanswered to give anyone the benefit of the doubt at this point. Needless to say, I'm not a fan of this article for a number of reasons.

Highabove
09-03-2012, 10:59 PM
Mr Greed,
Did you see my direct quote from J.J. Hardy? I will give you more documentation of a Player complaint.
Here is one from Pat Neshek
On May 5th 2010, Phil Mackey reported that Pat Neshek had made the following statements on his Facebook Account.

"Yeah it’s been a drag on me. Here’s what’s going on. I injured my finger about 3 weeks ago, got a cortisone shot in the finger and told to rest for a week. The pain never went away but my finger felt a little better. During the entire time throwing I have not felt that well out there playing catch (painful to grip and release the ball) and in games. I pitched with pain since the initial diagnosis said that it would go away and throwing a baseball would help it. Well, 3 weeks have passed and I’m still having trouble gripping a ball. (I went in for an MRI and to a hand specialist and learned that I was misdiagnosed.) My pain was coming from near the palm of my hand where my middle finger in my palm…called a pulley tendon. The best thing to help it is a direct injection of cortisone, rest, not to stretch it or use it doing things that put stress on it. To get a cortisone injection I need to wait at least 4 weeks after my last one. I had my last one 3 weeks ago. (I’m not happy with anything that has gone on especially when it could have been taken care of 3 weeks ago and was told the wrong info.)

Shane Wahl
09-03-2012, 11:02 PM
Well, I guess the only answer to this is to actually find out how other teams handle these situations and make the comparison with the Twins. That WOULD give us a sense of how bad the doctor-manager/coaches-players dynamic works with regard to these debacles. I think it is NOT a low priority . . . it only seems like that when the Twins are losing like this.

OldManWinter
09-03-2012, 11:12 PM
Sometimes poor results are nothing more than bad luck.

Most people I know do not own a perfect crystal ball so they have a real tough time knowing exactly what will happen in the future.

Apparently though, this site is full of good folks with perfect crystal balls that permit them to judge the future exactly right every time.

Baseball is a game to enjoy, don't over complicate it.

jokin
09-03-2012, 11:16 PM
Mr Greed,
Did you see my direct quote from J.J. Hardy?
Now I will give you one from Pat Neshek
On May 5th 2010, Phil Mackey reported that Pat Neshek had made the following statements on his Facebook Account.

"Yeah itís been a drag on me. Hereís whatís going on. I injured my finger about 3 weeks ago, got a cortisone shot in the finger and told to rest for a week. The pain never went away but my finger felt a little better. During the entire time throwing I have not felt that well out there playing catch (painful to grip and release the ball) and in games. I pitched with pain since the initial diagnosis said that it would go away and throwing a baseball would help it. Well, 3 weeks have passed and Iím still having trouble gripping a ball. (I went in for an MRI and to a hand specialist and learned that I was misdiagnosed.) My pain was coming from near the palm of my hand where my middle finger in my palmÖcalled a pulley tendon. The best thing to help it is a direct injection of cortisone, rest, not to stretch it or use it doing things that put stress on it. To get a cortisone injection I need to wait at least 4 weeks after my last one. I had my last one 3 weeks ago. (Iím not happy with anything that has gone on especially when it could have been taken care of 3 weeks ago and was told the wrong info.)

I will put out another one tomorrow.



Uh Ohhhh...

This could get to be better than waiting for the next weekly installment of Breaking Bad. I've got a feeling that Highabove's Vince Gilligan-like sense of timing while breaking out a "quote a day" from disgruntled ex-Twins is going to break really real bad for the "pro-medical-ignorance-overblown-outrage-accusing-frustrated-casual-observers-of-being-quacks-camp."

jokin
09-03-2012, 11:23 PM
]Sometimes poor results are nothing more than bad luck. [/B]

Most people I know do not own a perfect crystal ball so they have a real tough time knowing exactly what will happen in the future.

Apparently though, this site is full of good folks with perfect crystal balls that permit them to judge the future exactly right every time.

Baseball is a game to enjoy, don't over complicate it.

Except the Twins have defied the bad luck probabilites-threshold a long time ago. It's as if the Twins- to paraphrase Cream by way of blues great, Albert King- "didn't have bud luck, they'd have no luck at all.-

Highabove
09-03-2012, 11:54 PM
Here is a recent statement from Carl Pavono

On August 21st, the Pioneer Press Quoted Carl Pavono's comments regarding the Misdiagnosis of his shoulder injury.

"It's too bad it took three months diagnose that," Pavano said from New York. "I could have been resting."Pavano hasn't pitched for the Twins since June 1 and scrapped a rehab start with Class A Fort Myers to see Altchek on Tuesday, Aug. 21. Twins doctors diagnosed Pavano with a strain in his shoulder capsule, but he said Altchek said the primary culprit is the bruise, which is causing inflammation and pain.
"The good news is it doesn't require surgery," Pavano said. "I've had this in the past and gotten through it, and obviously I've pitched a lot since then. But as far as I'm concerned this whole season has been a failure on many levels, for myself, for the team. It's just kind of lousy that it took this long.


Scott Baker
On May 8th 2012, B.N. National Baseball editor Rob Neyer wrote about and quoted Baker following his TJ Surgery.

While Scott Baker worked through elbow issues over the past two seasons, the Minnesota Twins right-hander heard the whispers both inside and outside Target Field.
"I knew I wasn't crazy," Baker said Friday. "I knew there was some speculation that maybe I was babying it or taking it easy, but good grief. I did everything I possibly could to get better and to try to pitch with it. But that just wasn't going to happen."
Baker battled pain in his elbow dating to 2010, and some urged him to try pitching through the pain. He was shut down for the season earlier this month and scheduled for surgery on his flexor pronator tendon. But once his arm was opened up, Dr. David Altchek made the decision that he needed Tommy John surgery to repair the ulnar collateral ligament.

Don't Feed the Greed Guy
09-04-2012, 04:32 AM
From the Freelance Editor's Desk:

Mr. Highabove: Good work citing your claim: Sorry i missed the Hardy quote. The followups from Pavano, Neshek, and Baker substantiate your claim. That's good Journalism 101. Thank for the good reporting. You added to this thread.

BHtwins, you write: "The Twins medical staff is pretty poorly respected among the agent community as well. Some players agents wont let a primary diagnosis come from them at all."

Can you cite that? Something from the agent community?

I still would like to hear more from the sports medicine community. One post from an orthopedic doc. Any physical/sports therapists, or other qualified medical professionals? What's your take?

Sorry for being anal on the source thing, but I spent two years as a sports intern at a regional daily paper while in college. I hated it. Too many late nights waiting for the coaches to call in the Friday night scores between Dilworth-Glyndon-Felton and Fertile-Beltrami. And too much time proof-reading copy. But they taught me to document my sources. We can too.

take care.

Highabove
09-04-2012, 06:58 AM
I will put out a 5th Twins player.

Jason Kubel
Twins website September 27th 2011
Kubel in mid September, commenting on his foot injury.

"I don't like the way I went out and it's just been a frustrating season," Kubel said. "The initial thought [on May 30] was that it would be day to day and see how it goes, and it's still day to day now. But I guess it happens.
(We didn't give it the proper rest and it lingered all year.")

Brock Beauchamp
09-04-2012, 07:02 AM
Mr Greed,
Did you see my direct quote from J.J. Hardy? I will give you more documentation of a Player complaint.
Here is one from Pat Neshek
On May 5th 2010, Phil Mackey reported that Pat Neshek had made the following statements on his Facebook Account.

"Yeah it’s been a drag on me. Here’s what’s going on. I injured my finger about 3 weeks ago, got a cortisone shot in the finger and told to rest for a week. The pain never went away but my finger felt a little better. During the entire time throwing I have not felt that well out there playing catch (painful to grip and release the ball) and in games. I pitched with pain since the initial diagnosis said that it would go away and throwing a baseball would help it. Well, 3 weeks have passed and I’m still having trouble gripping a ball. (I went in for an MRI and to a hand specialist and learned that I was misdiagnosed.) My pain was coming from near the palm of my hand where my middle finger in my palm…called a pulley tendon. The best thing to help it is a direct injection of cortisone, rest, not to stretch it or use it doing things that put stress on it. To get a cortisone injection I need to wait at least 4 weeks after my last one. I had my last one 3 weeks ago. (I’m not happy with anything that has gone on especially when it could have been taken care of 3 weeks ago and was told the wrong info.)

On August 21st, the Pioneer Press Quoted Carl Pavono's comments regarding the Misdiagnosis of his shoulder injury.

"It's too bad it took three months diagnose that," Pavano said from New York. "I could have been resting."Pavano hasn't pitched for the Twins since June 1 and scrapped a rehab start with Class A Fort Myers to see Altchek on Tuesday, Aug. 21. Twins doctors diagnosed Pavano with a strain in his shoulder capsule, but he said Altchek said the primary culprit is the bruise, which is causing inflammation and pain.
"The good news is it doesn't require surgery," Pavano said. "I've had this in the past and gotten through it, and obviously I've pitched a lot since then. But as far as I'm concerned this whole season has been a failure on many levels, for myself, for the team. It's just kind of lousy that it took this long.

Scott Baker
On May 8th 2012, B.N. National Baseball editor Rob Neyer wrote about and quoted Baker following his TJ Surgery.

While Scott Baker worked through elbow issues over the past two seasons, the Minnesota Twins right-hander heard the whispers both inside and outside Target Field.
"I knew I wasn't crazy," Baker said Friday. "I knew there was some speculation that maybe I was babying it or taking it easy, but good grief. I did everything I possibly could to get better and to try to pitch with it. But that just wasn't going to happen."
Baker battled pain in his elbow dating to 2010, and some urged him to try pitching through the pain. He was shut down for the season earlier this month and scheduled for surgery on his flexor pronator tendon. But once his arm was opened up, Dr. David Altchek made the decision that he needed Tommy John surgery to repair the ulnar collateral ligament.


I don't think anyone here is saying the medical staff is without fault and some of those comments are certainly damning.

But that information is still incomplete, especially if you're trying to make a case to fire the "Twins medical staff". Who were these doctors? Were they the same person? Were they even part of the Twins' medical staff? How many different people came to this same conclusion about that particular injury? Is "rest and rehab" a part of the training staff's job or does the medical staff make that call? Are those two groups the same thing? We know so little about both the medical profession and this portion of the Twins organization that we're still firing shots in the dark.

Highabove
09-04-2012, 07:22 AM
Mr Greed,
Did you see my direct quote from J.J. Hardy? I will give you more documentation of a Player complaint.
Here is one from Pat Neshek
On May 5th 2010, Phil Mackey reported that Pat Neshek had made the following statements on his Facebook Account.

"Yeah it’s been a drag on me. Here’s what’s going on. I injured my finger about 3 weeks ago, got a cortisone shot in the finger and told to rest for a week. The pain never went away but my finger felt a little better. During the entire time throwing I have not felt that well out there playing catch (painful to grip and release the ball) and in games. I pitched with pain since the initial diagnosis said that it would go away and throwing a baseball would help it. Well, 3 weeks have passed and I’m still having trouble gripping a ball. (I went in for an MRI and to a hand specialist and learned that I was misdiagnosed.) My pain was coming from near the palm of my hand where my middle finger in my palm…called a pulley tendon. The best thing to help it is a direct injection of cortisone, rest, not to stretch it or use it doing things that put stress on it. To get a cortisone injection I need to wait at least 4 weeks after my last one. I had my last one 3 weeks ago. (I’m not happy with anything that has gone on especially when it could have been taken care of 3 weeks ago and was told the wrong info.)

On August 21st, the Pioneer Press Quoted Carl Pavono's comments regarding the Misdiagnosis of his shoulder injury.

"It's too bad it took three months diagnose that," Pavano said from New York. "I could have been resting."Pavano hasn't pitched for the Twins since June 1 and scrapped a rehab start with Class A Fort Myers to see Altchek on Tuesday, Aug. 21. Twins doctors diagnosed Pavano with a strain in his shoulder capsule, but he said Altchek said the primary culprit is the bruise, which is causing inflammation and pain.
"The good news is it doesn't require surgery," Pavano said. "I've had this in the past and gotten through it, and obviously I've pitched a lot since then. But as far as I'm concerned this whole season has been a failure on many levels, for myself, for the team. It's just kind of lousy that it took this long.

Scott Baker
On May 8th 2012, B.N. National Baseball editor Rob Neyer wrote about and quoted Baker following his TJ Surgery.

While Scott Baker worked through elbow issues over the past two seasons, the Minnesota Twins right-hander heard the whispers both inside and outside Target Field.
"I knew I wasn't crazy," Baker said Friday. "I knew there was some speculation that maybe I was babying it or taking it easy, but good grief. I did everything I possibly could to get better and to try to pitch with it. But that just wasn't going to happen."
Baker battled pain in his elbow dating to 2010, and some urged him to try pitching through the pain. He was shut down for the season earlier this month and scheduled for surgery on his flexor pronator tendon. But once his arm was opened up, Dr. David Altchek made the decision that he needed Tommy John surgery to repair the ulnar collateral ligament.


I don't think anyone here is saying the medical staff is without fault and some of those comments are certainly damning.

But that information is still incomplete, especially if you're trying to make a case to fire the "Twins medical staff". Who were these doctors? Were they the same person? Were they even part of the Twins' medical staff? How many different people came to this same conclusion about that particular injury? Is "rest and rehab" a part of the training staff's job or does the medical staff make that call? Are those two groups the same thing? We know so little about both the medical profession and this portion of the Twins organization that we're still firing shots in the dark.


Yesterday I stated the following,
"Comments by Players who have had issues with their treatment have been documented in the Print and Broadcast Media"

Several Forum Members have requested documentation which supports such a claim.
I have attempted to document the comments of five Twins Players.
That's it.

Brock Beauchamp
09-04-2012, 07:33 AM
Yesterday, I stated that a number of Twins players were not happy with their Medical Treatment.
Several Forum Members have requested documation which supports such a claim.
I have attempted to document the comments of five Twins Players.
That's it.

My comments weren't necessarily aimed at you. Thanks for compiling those quotes, they definitely add to the conversation. I believe that there is something wrong with the Twins organization in regards to training and/or medical issues (or maybe even the front office itself). There are too many back-and-forths with players saying they expect a return on this date, miss it, and then end up hitting the DL with or without surgery. It's terribly inconsistent. Even JR has stated that it's something he planned to fix when he returned to the GM spot so you know it's something the organization is worried about.

On the other hand, which injuries were borne out of negligence? Which were a simple misdiagnosis that any physician could have made? Which were the "at fault" injuries and which were nothing more than a dose of bad luck and/or player misinformation?

Again, we don't know. If the front office does nothing over the next six months, I'll be disappointed in the lack of action (it's also possible they plan to change their internal procedures and we'll never know about it) but I'm also not going to go shooting my mouth off, pretending that I know about things that are far beyond my scope of knowledge.

old nurse
09-04-2012, 07:59 AM
I'm not a staff writer for Strib or PP. I'm a poster on a message board. Im not getting paid to waste time.

Pay me free lance rates and Ill find you at least 5 quotes from players over the last 18 months complaining about the Twins med staff blowing their diagnosis. The fact is I found them....but Im not citing them because I DONT CARE. You cite them if this matters to you.

I'll find paragraphs of written angst from Joe Mauers torn meniscus taking too long. Weeks of written screed about shutting Liriano down to "rest" before he ultimately got TJ. Throw in some beautiful quotes of the staff questioning Grant Balfour's toughness when he complained of forearm tightness that ultimately turned into TJ. All of those are over 5 years ago. There are dozens of examples of Twins players getting 2nd and 3rd opinions and you'd have a tough time finding any major Twins player that had anything ortho done in-house.

If you think things are great....then fantastic. I dont care, I stated my opinion, which in general is a hell of lot more interesting then regurgitated tripe.

Opinion is one thing, claiming agents say things is another.

Brock Beauchamp
09-04-2012, 08:06 AM
I'm not a staff writer for Strib or PP. I'm a poster on a message board. Im not getting paid to waste time.

Pay me free lance rates and Ill find you at least 5 quotes from players over the last 18 months complaining about the Twins med staff blowing their diagnosis. The fact is I found them....but Im not citing them because I DONT CARE. You cite them if this matters to you.

I'll find paragraphs of written angst from Joe Mauers torn meniscus taking too long. Weeks of written screed about shutting Liriano down to "rest" before he ultimately got TJ. Throw in some beautiful quotes of the staff questioning Grant Balfour's toughness when he complained of forearm tightness that ultimately turned into TJ. All of those are over 5 years ago. There are dozens of examples of Twins players getting 2nd and 3rd opinions and you'd have a tough time finding any major Twins player that had anything ortho done in-house.

If you think things are great....then fantastic. I dont care, I stated my opinion, which in general is a hell of lot more interesting then regurgitated tripe.

Opinion is one thing, claiming agents say things is another.

Yeah... You can't claim that people have said and done all these things and then say "I don't feel like looking it up" when someone asks for quotations.

But yes, "opinions" are often more interesting than "truth"... Just ask Fox News. Taking that position also makes it impossible for me to take you seriously because, for all I know, you're just making crap up and/or distorting reality to fit your talking points (again, like Fox News).

Boom Boom
09-04-2012, 08:22 AM
On the Span situation... I'm not so much bothered by the medical staff.

What bothers me is that it took so long to DL Span when there was no logical reason to keep him on the roster. If the Twins really thought he could be back in a couple days, and if they were in position to play meaningful games, I can see how you might hesitate to DL him. None of that has to do with the medical staff but rather with the coaches and Span himself.

Brock Beauchamp
09-04-2012, 08:25 AM
On the Span situation... I'm not so much bothered by the medical staff.

What bothers me is that it took so long to DL Span when there was no logical reason to keep him on the roster. If the Twins really thought he could be back in a couple days, and if they were in position to play meaningful games, I can see how you might hesitate to DL him. None of that has to do with the medical staff but rather with the coaches and Span himself.

I have speculated that the Span situation was a front office decision. If you're planning to trade a guy in the offseason, avoiding the DL in favor of sitting him for 8-10 days looks better on paper. After he came back and was injured again (or still had the same injury), they couldn't avoid the DL any longer. Again, this is all just speculation but if you can avoid using the DL to shelve a player you want to trade in ~3 months, it makes sense to just bench him for a week and see what happens.

Boom Boom
09-04-2012, 09:11 AM
On the Span situation... I'm not so much bothered by the medical staff.

What bothers me is that it took so long to DL Span when there was no logical reason to keep him on the roster. If the Twins really thought he could be back in a couple days, and if they were in position to play meaningful games, I can see how you might hesitate to DL him. None of that has to do with the medical staff but rather with the coaches and Span himself.

I have speculated that the Span situation was a front office decision. If you're planning to trade a guy in the offseason, avoiding the DL in favor of sitting him for 8-10 days looks better on paper. After he came back and was injured again (or still had the same injury), they couldn't avoid the DL any longer. Again, this is all just speculation but if you can avoid using the DL to shelve a player you want to trade in ~3 months, it makes sense to just bench him for a week and see what happens.

I really doubt that's the case. Teams aren't usually going to balk from a trade because of a clavicle injury caused by a collision. That's not usually the kind of injury that will chronically reappear.

CDog
09-04-2012, 10:09 AM
Scott Baker
On May 8th 2012, B.N. National Baseball editor Rob Neyer wrote about and quoted Baker following his TJ Surgery.

While Scott Baker worked through elbow issues over the past two seasons, the Minnesota Twins right-hander heard the whispers both inside and outside Target Field.
"I knew I wasn't crazy," Baker said Friday. "I knew there was some speculation that maybe I was babying it or taking it easy, but good grief. I did everything I possibly could to get better and to try to pitch with it. But that just wasn't going to happen."
Baker battled pain in his elbow dating to 2010, and some urged him to try pitching through the pain. He was shut down for the season earlier this month and scheduled for surgery on his flexor pronator tendon. But once his arm was opened up, Dr. David Altchek made the decision that he needed Tommy John surgery to repair the ulnar collateral ligament.




Of course you "forgot" this (from 1500 ESPN, but I'm fairly certain it was elsewhere, as well). Starting to feel like Groundhog Day. Bolding is mine. ...

Manager Ron Gardenhire and pitching coach Rick Anderson wanted Baker to cut it loose, provided he was healthy enough to be on the mound.

In retrospect, it's clear now why Baker was unable to ramp up into the 90's, but when asked if there were any hard feelings between he and the coaching staff Baker said, "None whatsoever."

"Nobody knows what's going on," he added. "Nobody knows what's going on until you get in there. I didn't know, doctors don't know. The doctors don't know until they get in there. I mean, they can have an indication from an MRI, but what can you do until you get in there? ...

"To be honest with you, you're not always completely forthright with the staff."

Nick Nelson
09-04-2012, 10:25 AM
In the Baker example, his elbow was checked by multiple specialists (including the guy that eventually did his surgery) and NOBODY knew what the deal was until they opened him up. This is what I'm talking about when I refer to the complexity of these situations and the mysteries of medicine.

Anyway, I'm glad that the post has generated some interesting discussion. Certainly there are some strong and legitimate points being made against this team's process when it comes to injuries. I was never denying that. All I'm asking people to do is think about the situation in context, and maybe look at the big picture before throwing out blanket accusations.

BHtwins
09-04-2012, 10:35 AM
Rocket, its not that I dont care or dont want to. I dont have time, or rather I'm not going to take the time for a wasted argument to prove something I know exists. Same with the agent thing. It exists and there is enough ancillary evidence to know whats going on. Again, I'm not trying to sway your opinion one way or the other because clearly it doesnt matter.

People here spend all this wasted energy to prove a negative and I'm not going to do it. I'm not trying to get discovered by ESPN.com for my leet writing ability and I dont care if you dont think my opinion is valid or not. If you don't....then skip it. Theres enough garbage and good stuff here and everywhere on the internet to fit your view and validate your opinion.

Thats not why I posted it in the first place. I posted to argue the point that A) It hasnt been 2 years. B) Its not just Twins fans.
If you dont believe that...then skip it. Dont care.

(This is pure opinion) I have no earthly idea whether the Twins med staff is good or bad or just has had a string of bad luck. I do have enough life experience to know that doctors are not infallible. So my suspicion is that there probably arent a lot different then any other middling MLB franchises medical staff. If results matter though ( and they should) then their track record sucks lately and that isnt opinion thats cold hard fact.

StormJH1
09-04-2012, 10:52 AM
Nick, the gist of your article seems to be that Twins fans think the medical staff are "bad doctors". That is not what the criticism is. I think there's a cultural problem throughout the organization and when we say "medical staff", what we really mean is the interplay between the physicians, the players themselves, Gardenhire, and the front office as to how injuries are appropriately handled.

I'd imagine that any highly-trained physician is predisposed to diagnose and fix problems as expediently as possible. With a Scott Baker situation, there's a gray area where you just don't how bad the damage is until they cut into his arm. Ultimately, the decision as to whether or not they can go in is Baker's, so maybe HE resisted, at his own expense.

Reusse believed on the radio that Span's DL immediately before the 40-man roster expansion was meant as a punishment for not properly reporting his issues. I think the physicians and management are often at the mercy of the players to accurately report their symptoms. But I also think that the Twins as a whole perpetuated a culture of encouraging guys to play hurt, and celebrating the guys like Redmond, Punto, Cuddyer, Pavano, etc. who played hurt, even if they did so with terrible results. And to go along with that, the most prominent player on the team (Mauer) had several injury-plagued seasons where he was basically given free reign to let Gardenhire know on very short notice that he wasn't able to go that night. So is it right to punish guys like Span who essentially are doing exactly what it seems the Twins expect them to do, which is to play as much and complain as little as possible?

OldManWinter
09-04-2012, 11:25 AM
Remember the difference between facts and opinions.

Players, agents, doctors, or therapists remarks are all basically opinions ... especially discussing success of surgical procedures and recovery times.

It is way too easy to try and convert all of this secondhand information into fact in our minds and the basis for our argument.

But, we really don't know much more than we have had lots of injuries and not all healed.

Suspicious people form one conclusion, accepting people another.

one_eyed_jack
09-04-2012, 06:36 PM
It's the continuing pattern which is the cause for concern.
Nick, are you in the Medical Profession ?
If so, I will give more weight to your comments.

----Did you actually read what Nick wrote?

To be clear, I'm not saying that the Twins' medical staff compares well to the rest of the league. They might even be among the worst. But I don't believe we have the evidence to make that assessment. Judging a doctor's performance isn't like judging a pitcher, or hitter, or manager, or GM. Each situation is unique and there are lot more factors in play than some would assume.

These comments need not come from a medical expert to be given weight.

I read him to be pointing out that the constant railing on the medical staff is coming from people who have neither the knowledge nor expertise to make educated evaluations of their performance, which unlike judging a player, is infinitely more complex than just making conclusions based on outcomes.

This sentence is actually pretty incorrect... Medical performance has always been judged based on outcomes, and in probably 2-3 years (some pilots are up and running now - google: ACO), most doctors will be "paid for performance" (where "performance" is mostly outcomes.)

As far as the Twins' situation goes, there are a lot of issues, including the doctors; but players and especially management have to take some of the blame for the waiting for Godot to go to the DL... Missdiagnosis, is another story

---Nice try, but what you're raising here is completely irrelevant..

Most of the criticisms of the Twins medical staffs here have been based solely on end results of treatment. That is not how ACO pay-for-performance standards work. At all. They don't say "well, the patient died, so the doctor must have done a crappy job." Medical professionals have never been judged that way, and it would be completely senseless to do so. ACO's are looking at trends in how improved practices can lead to better outcomes. It's about best practices, not end results. Sometimes doctors do all that is humanly possible, but the outcome is not the one everyone was hoping for.

Fire Dan Gladden
09-04-2012, 07:59 PM
As usual, people are trying to make 1+1=7. Take any of the aforementioned injury situations. What do we have:

-What appears to be questionable decisions made from the Twins organization regarding DL decisions
-Veiled comments from frustrated ex-players that their injuries were not handled appropriately by the Twins organization
-No real public responses from the Twins on either item

Let's see what we don't know:
-How many doctors were in on the diagnosis?
-How did the player respond to the initial diagnosis?
-Did the players follow the directions of the doctors, or go on their own?
-Were there any setbacks during the healing process?

I could take this on and on, but you catch my drift.

Even if we make an assumption the Twins doctors erred in their work, we don't know who they were or if they are still employed with the team, or if changes have been already made in any capacity. All we have to go on is what is publicly reported or unnamed sources providing 2nd or 3rd hand knowledge. Yet many fans here use this as an excuse to call for personnel changes. Typical.

Let me say this again... We do not know anything about the situation.

USAFChief
09-04-2012, 08:43 PM
I could take this on and on, but you catch my drift.

Even if we make an assumption the Twins doctors erred in their work, we don't know who they were or if they are still employed with the team, or if changes have been already made in any capacity. All we have to go on is what is publicly reported or unnamed sources providing 2nd or 3rd hand knowledge. Yet many fans here use this as an excuse to call for personnel changes. Typical.

Let me say this again... We do not know anything about the situation.

We know more than you imply.

The Director, Medical Services is Dr John Stuebs. He has been with the Twins since 1986.

Other Twins orthopedic physicians include Dan Buss (since 1990), Dianne Dahm, and Pierce McCarthy.

Internal Medicine team physicians: Dr. Vijay Eyunni, Dr. Tom Jetzer, Dr. Amy Stromwell

Training staff is headed by Dr Rick Aberman. Trainers include Rick McWane and Perry Castellano.

All this information is publicly available. You can find it, for example, at MLB.com.

I took the time to look up how long Stuebs and Buss have been with the Twins, but didn't check the others. At the very least, the top of the medical staff has been with the Twins for a long, long time.

TheLeviathan
09-04-2012, 09:46 PM
I think the Twins and a few key "leaders" on the team being publically frontal about player "toughness" has been a major component of this problem that has often been overlooked. Hard to establish good, honest communication when you call people out to the press for being soft.

Fire Dan Gladden
09-05-2012, 07:22 AM
You have a list of names posted from the team media guide at the beginning of the year. You don't know what if any changes have been made since then. You don't know what level of authority they have (you can assume, but don't know for sure). You don't know how many 2nd or 3rd opinions were given from outside the organization. You don't know how the chain of command works within the medical portion of the organization.

I am not saying the medical staff is without fault. I am saying that everybody who wants to replace them doesn't know if they are replacing the "guilty" party. They are taking partial comments, a little fact, and a lot of opion and making broad stroke demands.

I repeat, we do not know anything about the situation.

USAFChief
09-05-2012, 12:18 PM
I repeat, we do not know anything about the situation.

No, YOU don't know anything about the situation. WE have learned some things.

Sticking one's fingers in one's ears and singing "la la la" doesn't mean information wasn't presented.

Brock Beauchamp
09-05-2012, 12:23 PM
I repeat, we do not know anything about the situation.

No, YOU don't know anything about the situation. WE have learned some things.

Sticking one's fingers in one's ears and singing "la la la" doesn't mean information wasn't presented.

Outside of a few names, that information doesn't tell us much of anything. We know the names of people, we still have no information regarding internal policy, who makes certain decisions (training or medical), or who "calls the shots". We don't even know if that information is current.

Personally, I think it's in the best interest of the organization that JR make some sort of public announcement this offseason. At least let us know they're doing something, even if it isn't a full disclosure of all internal operations regarding the medical and training staff.

Nick Nelson
09-05-2012, 12:27 PM
No, YOU don't know anything about the situation. WE have learned some things.
Such as? Looking up the names of the people on the team's medical staff doesn't really illuminate anything.

I guess the quotes from former players are somewhat damning, but I have hard time believing it doesn't happen in other organizations. My understanding is that friction between doctors & players/coaches is fairly common. And even if it's not, I haven't seen one post on this thread where anyone's been able to legitimately pinpoint a consistent source of blame for these medical mishaps.