October 05, 2026

For 30 years, Matthew Matava, MD, has had one of the best seats in professional sports. As a longtime team physician for the St. Louis Blues, his attention isn't on the scoreboard – it's on the athletes.

Three decades of caring for professional athletes have given Dr. Matava a perspective on team medicine that can't be learned from a textbook alone. Team physicians make consequential decisions in noisy arenas and on crowded sidelines, often with incomplete information and little time. They balance an athlete's desire to compete with short- and long-term health considerations. They work alongside athletic trainers, coaches, administrators and other medical specialists. And they do it while facing pressures that aren't typically present in an exam room.

So, what does it take to do the job well?

Dr. Matava recently shared the lessons he believes are essential to becoming an effective team physician. His first is also the most important.

1. Put the athlete first. Always.

A team physician may work for an organization, but the physician's primary responsibility is to the athlete.

That distinction matters because sports medicine introduces pressures that don't exist in a traditional physician-patient relationship. An athlete may want to keep playing, and coaches and management want to play a competitive team. At the professional level, contracts, roster positions and careers may be affected by an injury.

The physician has to consider those realities without allowing them to override what's best for the athlete. For Dr. Matava, everything else about being an effective team physician starts here.

2. Get comfortable making decisions with imperfect information.

Team physicians rarely have the luxury of ideal conditions.

An athlete may be injured on the field or ice with thousands of people watching. The environment can be loud and chaotic. Equipment may make an examination more difficult. The athlete may be agitated and eager to return to play. And the physician may need to make a decision quickly.

Dr. Matava's approach is straightforward: remain calm, control the situation, explain the plan and get help when you need it. The expectation may be a perfect decision, but the reality is that physicians often have to make the best possible decision with the information available at that moment.

3. Know the athlete, not just the injury.

Return-to-play decisions aren't made in a vacuum.

The same injury can have very different implications depending on an athlete's age, sport, position, competitive level, and circumstances. A veteran with an established career may view treatment options differently than a rookie fighting for a roster spot.

The physician's job is to make sure athletes understand their options and their potential consequences, so their individual goals and circumstances can be part of the decision.

4. Build your team before you need it.

A team physician never works alone.

Effective sports medicine depends on an entire network of professionals, including athletic trainers, primary care sports medicine physicians, orthopedic surgeons and other specialists.

Dr. Matava places particular emphasis on the relationship between physicians and athletic trainers. Athletic trainers are often the key connection between physicians, athletes, coaches and team administrators. They spend significant time with the athletes and may develop a level of trust that gives them insights a physician won't get during an examination.

Those relationships shouldn't begin when something goes wrong. Build them early. Respect everyone's expertise. Know who you can call when an athlete needs care outside your specialty.

Great teammates, Dr. Matava emphasizes, make a great team.

5. Prepare for the emergency before it happens.

One of the most important responsibilities in team medicine happens before the season begins.

Every venue should have an emergency action plan that addresses orthopedic, medical and environmental emergencies. The plan should establish a clear medical chain of command, identify available resources and define everyone's responsibilities. Practice it.

On game day, the medical team should know where emergency equipment is located, how an injured athlete will be evacuated, who is responsible for that evacuation and which hospital will receive the athlete if additional care is required.

As Dr. Matava puts it: Perfect practice makes perfect.

6. Leave your ego at the door.

Being the team physician doesn't mean having every answer.

High-profile athletes may have access to specialists across the country, and Dr. Matava believes effective team physicians should welcome that expertise rather than feel threatened by it.

Facilitate second opinions. Consider alternatives. Talk directly with consulting physicians. When appropriate, involve another specialist who knows more about a particular condition than you do.

The objective isn't to prove you're right. It's to get the athlete the best care possible.

7. Learn how to communicate under pressure.

Clinical expertise is only part of the job.

Team physicians have to communicate with athletes, athletic trainers, coaches, administrators, consultants and sometimes the media – all while protecting the athlete's privacy and maintaining appropriate professional boundaries.

Communication becomes particularly important after an injury. The medical team needs a clear follow-up and treatment plan, appropriate stakeholders need to understand next steps, and medical encounters need to be documented.

The ability to explain a complicated situation clearly and calmly can be just as important as making the diagnosis itself.

8. Support the team. Don't become a fan.

After 30 years as a team physician, this may be one of Dr. Matava's most distinctive pieces of advice.

Enjoy sports. Build relationships with players and coaches. Take pride in the organization you serve. But don't become a fan.

A fan desperately wants the star player back for the playoffs. A physician has to evaluate whether that player should be there.

That professional distance matters because the pressures surrounding an injured athlete can be enormous. Players want to play. Coaches want to win. Fans have expectations. And physicians aren't immune to those pressures themselves.

An effective team physician recognizes those influences and remains focused on the responsibility that matters most: caring for the athlete.

Thirty years on the sidelines have taught Dr. Matava that the job requires much more than sports medicine expertise. It takes preparation, humility, critical thinking, emotional intelligence, leadership and an ability to earn the trust of people throughout an organization.

And even after decades of experience, it requires continuing to learn. The best team physicians aren't simply doctors who happen to work in sports. They're great teammates, too.

Learn why patients choose WashU Medicine Orthopedics, request an appointment online or call (314) 514-3500.