AAFP Recognizes Contributions of Sports
Medicine Mentor
Oct. 31, 2024, David Mitchell — When Michael Petrizzi, M.D., FAAFP, started a faculty development fellowship at the University of North Carolina in 1986, he was asked to develop one area of expertise.
He declined.
“I said, ‘I can’t limit it,’” said Petrizzi, a clinical professor of family medicine at Virginia Commonwealth University School of Medicine in full-time practice in Mechanicsville, Va. “I wanted to become better at family-centered obstetrics, and I also wanted to become better at sports medicine.”
So, Petrizzi, who was recently honored by the AAFP with the Exemplary Teaching Award for Medical Education, became an expert in both of his passions.
His timing was excellent.
In the early 1990s, family physicians at the Medical College of Wisconsin developed an Advanced Life Support in Obstetrics course to help rural physicians learn and maintain emergency obstetric skills. The evidence-based course was purchased by the AAFP in 1993, eventually broadening its reach to thousands of physicians, residents, nurse midwives, registered nurses and others in dozens of countries.
“What they did was take a look at the most common emergencies that someone who does deliveries would encounter,” said Petrizzi who served as an ALSO instructor, course director and advisory faculty for more than two decades. “How can you either predict what might happen and therefore avoid it, or deal with problems such as shoulder dystocia? Over the course of the years that I was involved with it, we probably taught more than 500 residents.”
That course also gave Petrizzi inspiration to develop a different one that would address some of the most common issues a primary care physician might encounter in his other favorite setting — sports medicine. Petrizzi worked with Steve Cole, M.Ed., A.T.C., C.S.C.S., who was then the longtime head athletic trainer at the College of William & Mary, to develop Sideline Management Assessment Response Techniques, or SMART.
Petrizzi said the vast majority of U.S. high schools don’t have a team doctor. He pointed to an Association of American Medical Colleges report that identified an inadequate level of education in sports medicine in medical schools as a possible cause.
“It’s hard to not put the two together,” Petrizzi said. “Correlation does not equal causality, but the fact is that less than 20% of schools have a doctor because only 20% of us are trained well enough. The idea of the SMART course was to decrease a physician’s anxiety level by providing the knowledge and skills you might need to potentially backfill the educational gaps that had been occurring during medical school and even residency. Our hope is that everyone that’s there will teach it back at their residency or in their own community, so there will be more doctors on the sidelines.”
SMART, which is taught with live volunteers rather than mannequins, made its debut in 2003 at an AAFP sports medicine strategies course. It was first presented at the AAFP’s Scientific Assembly (now the Family Medicine Experience) that same year and has become a regular CME offering at both FMX and the American Medical Society for Sports Medicine’s annual conference.
Petrizzi has a long history of presenting sports medicine topics at AAFP CME events, dating back to 1993. He developed a splinting and casting workshop that made its debut at Scientific Assembly in 1995 and has been part of the Academy’s annual meeting more than 20 times.
Petrizzi has presented SMART and the splinting and casting workshops at numerous other AAFP, state chapter and sports medicine events. He added to his FMX agenda the past two years, presenting a therapeutic needling course with Navid Mahooti, M.D., M.P.H., of Beverly, Mass., who developed that course. Petrizzi said the aim of the newer course is to understand the concepts related to both muscles and fascia being a source of pain.
Petrizzi’s work isn’t done, either. This spring, SMART was published as a manual along with a pocket guide and an app. He is pursuing CME accreditation for the manual, as well as funding so the book can be provided to high school athletics programs.
The manual has more than 100 QR codes linking to videos that show users how to examine all the major joints, as well as how to do things like stabilize a neck injury or relocate a joint.
“This has been a passion project that I've wanted to do my whole career,” he said, “and it’s based on the people that taught me how to do things.”
At the top of that list is Edward Shahady, M.D., FAAFP, who was chair of the UNC Department of Family Medicine when Petrizzi was a resident. Petrizzi was thrilled when he got to fill the role of team physician for a local high school during his intern year, working alongside Shahady.
“I got to be on the sidelines and got to start filling that gap and seeing what a tremendous place you could have in your community by being able to interact with adolescents and others,” he said. “If it was a home game, Ed would pick me up, bring me to his house and feed me dinner with his kids and his wife before the game. If it was an away game, we’d get in the car and he would buy me a hot dog at the stadium.”
More important than the hot dogs were the conversations he had with his mentor on those road trips. One in particular stands out.
“He said, ‘Mike, I think you’ve got the bug,’” said Petrizzi, a longtime member of the Society of Teachers of Family Medicine’s committees and task forces related to sports medicine and maternity care. “I said, ‘What do you mean?’ He said, ‘You just look like you really enjoy teaching.’ He saw the glint in my eye when I was talking to a patient, an intern or a medical student, and he helped to foster that development. He helped me see the benefits of things like staying on to do the faculty development fellowship. He also introduced me to STFM. Once I start something, I want to do it all the way, so I’ve never missed a meeting.”
Petrizzi has been the team doctor for Atlee High School in Mechanicsville, Va., since it opened in 1991. Students and residents with an interest in sports medicine work with him every fall.
“I have a number of folks who were with me as students or residents that are now sports medicine docs, who are contributing to the literature or providing that service,” he said. “I’m just doing what Ed Shahady taught me to do.”