Growing up in San Antonio, becoming the Spurs’ team doctor and helping the team win all five of its championships has been a dream come true for Paul Saenz, D.O. We asked him about how his training in osteopathic medicine prepared him for a successful sports medicine career.
How did you become the San Antonio Spurs’ team physician?
I had been in practice for 10 years and had established myself as San Antonio’s first fellowship-trained primary care sports medicine physician. I had become a national team physician for U.S. Boxing and was on the medical staff for the1996 Olympic Games.
The Spurs have always been a forward-thinking organization and wanted to complement and diversify their medical staff with a physician trained to treat their athletes comprehensively; from both a musculoskeletal and medical perspective.
I had been working with the Spurs team orthopedist on a number of local sporting events and he recommended me when the position became available just prior to the 1998-99 season. Being a native San Antonian and growing up a huge Spurs fan, it was a dream come true.
We won San Antonio’s first NBA Championship in my first season as team physician. After getting a chance to hold the Larry O’Brien trophy on the court in hallowed Madison Square Garden with the confetti still falling, I had to pinch myself real hard to believe it was really happening. Truly one of the best memories of my professional career!
How has your osteopathic medicine training influenced your career and how you treat patients?
My educational foundation, based in the osteopathic principles of a holistic approach to treating patients comprehensively — mind, body, and spirit — could not have prepared me any more purposefully for my chosen specialty of primary care sports medicine.
This specialty requires the applications of a firm understanding of human physiology and its metabolic process, applied in a preventive medicine approach to the treatment of highly trained athletes.
The enhanced understanding of the musculoskeletal system, from both a functional anatomical and biomechanical perspective, is constantly employed in my clinical practice, and has produced professional gratification in allowing me to impart some of this knowledge to the medical students, residents, and fellows that I train. The ability to apply my osteopathic manipulative skills in the office and training room have set me apart from non-osteopathic trained specialists.
Describe your most memorable moment working as the Spurs’ team physician.
It is difficult to single out one special memory as there have been so many. I am in my 23rd year with the team and have been a part of all five of our NBA Championships. Flying on the team plane, staying in the hotel, sharing meals with the coaches and players, and riding in the team bus to a Game 7 are each prized and indelible memories.
The pride and emotion of playing a role in one of the most successful sports franchises in history is vividly realized with the culmination of a championship season and becomes an eternal memory. Individual moments treating future Hall of Fame players or a new rookie with a serious or concerning injury also comprise memories of a career I could only have dreamed of.
On a humorous note, there was an instance during my first year with the team. I was observing my partner evaluating the knee of our point guard in the training room before a first-round playoff game, and didn’t realize our MVP Tim Duncan was standing right behind me.
I took a step back and smashed his toe with the heel of my dress shoe. As he howled in pain, I instantly thought that my future as the Spurs’ team physician was over as quickly as it had started, but fortunately Tim went off for something like thirty points that night and saved my career!
What do you want people to know about D.O.s?
I think above all I want people to know that Osteopathic Medicine is mainstream medicine, not alternative medicine. I’m sure thousands of the patients I’ve treated over my 32 tears in practice did not necessarily choose me because I am a D.O. They likely received a favorable recommendation of my practice, or were referred by a friend or colleague.
However, I would like to believe that those patients who stayed loyal to me and who brought their parents or children to me did so because I am a D.O. I truly believe that we treat patients uniquely different with a compassionate, individualized, hands-on approach. I am so grateful for my osteopathic foundation, and so proud of the growth and acceptance of our profession.
What advice do you have for people interested in sports medicine?
The first piece of advice I give to an undergraduate student who says “I want to do what you do” is to first be sure that they truly understand what it requires of an individual to become a physician.
The commitment and discipline necessary to survive medical school then residency can be underappreciated and under-contemplated. Tremendous financial and personal sacrifices are made during the early years of training and even beyond. Even for the most intellectually gifted individuals, it’s “no cakewalk.”
For those medical students and residents who have decided to pursue the specialty of sports medicine, I advise you to start “building your resume” as soon as possible. Obtaining a fellowship position has become extremely competitive, so compiling an array of sport event coverage, participating in research, and presenting a poster at an annual sports medicine conference all contribute to a strong application.
I remind them that all fellowship programs, as their highest priority, look for applicants that are first “good physicians,” so choosing the residency where one can obtain the best training is tantamount to success during the match.
Lastly, while the specialty of sports medicine sounds “sexy” with the appeal of caring for highly competitive and elite athletes, one needs to remember that the specialty focuses on the broad spectrum of athletes; from kids to weekend warriors to seniors trying to remain healthy, and that’s also what makes it so gratifying.
What is it like to be in charge of the medical care for a professional sports team during the COVID-19 pandemic?
It’s probably safe to say that every American’s job or professional role has been affected to some degree by the Coronavirus pandemic. Suffice it to say that my role as team physician for the Spurs has been more demanding over the past 12 months than any other period of my 23 years with the team.
From March 11th, 2020, the day the NBA announced the suspension of the 2019-20 season, through the present, there have been innumerable hours spent between Zoom conferences, emails, and daily texts between league officials, Spurs front office management, and our team medical staff. Each of these meetings and conversations have concentrated on establishing the most comprehensive health and safety guidelines for the players, coaches, medical personnel, and traveling staff.
Team physicians in each NBA market have been involved in this arduous and dynamic task. The NBA has teamed with world-renowned institutions, such as the CDC, and Johns Hopkins and Yale universities, to develop best practices and standard-of-care guidelines that are expansive and include sequential COVID-19 testing for all team members, as well as essential organization and facility employees (this articulately constructed manual is 158 pages long!).
Out of necessity, hygiene and cleansing protocols for arenas and practice facilities have been templated and implemented in each market. Myself and other select members of the medical staff are required to monitor for adherence and compliance.
No organization of this size has been immune from individuals who have become infected with SARSCoV2, and we are no different. Daily testing means daily surveillance of results. A positive result generates a text and email, usually received in the wee hours of the morning. This is where things require algorithmic management but can get very complicated.
The affected individual is expediently notified, questioned regarding symptoms, and instructed to self-isolate. Treatment is initiated depending on severity. Coordination of care with an infectious disease specialist and a hospital system have already been established should the situation become critical.
Vitally important to containing spread within the team is contact tracing. Who else had close exposure and for how long? These answers affect both the individual’s and team’s ability to practice or play a scheduled game. Dozens of NBA games have been cancelled so far this season as a result.
This is only the tip of the iceberg, because if this happens while the team is on a road trip, then a lot of telemedicine becomes necessary. For obvious reasons, isolated or quarantined individuals are prohibited from traveling with the team, requiring medical management from afar.
So when asked how my job as a team doc has been affected by the pandemic, I’d simply respond: Taking care of a sprained ankle has never seemed so easy!
