HL20: James Andrews - Preventing Kids' Sports Injuries

This article was published on December 2, 2010.

 "We're all for sports—they're the greatest thing in the world for our kids—but the motto is to keep kids on the playing field and out of the operating room."

In our annual HealthLeaders 20, we profile individuals who are changing healthcare for the better. Some are longtime industry fixtures; others would clearly be considered outsiders. Some are revered; others would not win many popularity contests. All of them are playing a crucial role in making the healthcare industry better. This is James Andrews' story.

He's arguably the godfather of a subspecialty in healthcare that pioneered minimally invasive surgical techniques for shoulders, elbows, and knees using the arthroscope and magnetic resonance imaging that are now frequently used in surgeries far outside the orthopedic sphere.

He's also world-famous for being the go-to guy for injured super-athletes with multimillion-dollar contracts.

You'd think that man would be a little more self-aggrandizing, and, well, egotistical. But you'd be very wrong.

In fact, you get the feeling that Andrews talks to the media because he knows it's necessary to help achieve his goals on sports injury prevention, but what he's really interested in is the next case. In fact, HealthLeaders caught up with him between two surgeries.

Athletes with millions of dollars resting on the outcome of their surgeries trust him, and have for a couple of decades now. James Andrews, MD, whose name is almost always mentioned in association with surgeries on franchise athletes such as Washington Redskins quarterback Donovan McNabb, New Orleans Saints quarterback Drew Brees, or St. Louis Cardinals slugger Albert Pujols, has become a celebrity himself.

"You have to take the celebrity in stride. I've never let that interfere with my basic core values to take care of people at all levels," he says. "In fact, it's added pressure to my life and added extra workload."

Sucked into the spotlight, Andrews is content to give a lot of the credit for his success to his team, which he compares to a NASCAR pit crew. It consists of his physician partners in his two practices in Birmingham, AL, and Gulf Breeze, FL, his PR man, the chief of his charitable foundation, the 11 fellows he takes on at his two practices each year. Soon, he's talking about the importance of the secretaries and the maintenance personnel before a reporter is able to return to the focus of the interview—him and his work.

Despite the obvious value of his service to high-paid athletes, none of that is why Andrews is on the HealthLeaders 20 list for 2010. Though he made his money and fame in surgery, in recent years, and as the end of his career approaches, Andrews is spending an awful lot of time, money, and effort on prevention. It's the sort of work that provides a good example for hospitals that are struggling to find ways to integrate prevention into their processes as reimbursement begins to shift away from the fee-for-service model.

"For years we've spent most of our efforts in developing surgical techniques to fix athletic injuries, but we've been neglecting the prevention area," he says. "But prevention is more important than treatment."

Truthfully, this isn't a recent shift for Andrews. He's been working to prevent injuries in youth sports for about 10 years, ever since the founding of the American Sports Medicine Institute in Andrews' adopted hometown of Birmingham, AL. The difference now is, he says, "finally, it seems people are really ready to get involved in prevention of injuries for our young kids."

The problem, he says, is reflected in a five- to sevenfold increase in youth sports injuries since 2000.

"Prevention is common sense if you understand the risk factors, but that education is a massive job," he says. "We'll never prevent all injuries, but it'll take us 10 years to get the injury rates back down where they're acceptable. We're all for sports—they're the greatest thing in the world for our kids—but the motto is to keep kids on the playing field and out of the operating room."

ASMI offers education, training programs, and conferences for parents, nurses, coaches, and athletes to help get the information out. Last year, as president of the American Orthopedic Society of Sports Medicine, Andrews initiated a national program called the STOP (Sports Trauma and Overuse Prevention) campaign, and pediatricians, nurses, physical therapists, and others have gotten behind this campaign to try to educate parents, grandparents, national media, coaches, and athletes about the statistics surrounding sports injuries. As its name suggests, overuse has become a significant concern as kids move increasingly toward playing one sport year-round. Its website, offers loads of educational information about injuries attributed to activities particular to specific sports, and offers guidelines for guardians about preventing injuries that require surgery—an outcome that can end a kid's athletic dreams much too early.

"We have to change the system in some 20 sports that are involved in this campaign. It's a massive job," Andrews says.

Some of his admittedly little time away from the OR is spent helping to recruit medical talent to STOP's scientific advisory board. Those people add to the information and learning opportunities about sports injuries and how they develop.

"That's my passion and really what I'm proud of," he says.

Asked how he manages to treat all his patients the same regardless of their celebrity, Andrews has a simple credo that should work whether one is an accomplished surgeon or, for example, a hospital senior leader.

"Show a lot of confidence, don't make it too complicated, and don't beat around the bush," he declares. "People can read between the lines if you don't act like you know what you're doing."

Listen to audio interview with James Andrews, MD.