The New Reality for Team Doctors in the NIL Era: Liability, Pressure, and a Shifting Relationship

In 2023, a jury sent shockwaves through the world of sports medicine when it awarded former Philadelphia Eagles player Chris Maragos $43.5 million in damages for lost future earnings and pain and suffering. Maragos alleged that improper care of a knee injury by his surgeon and an orthopedic group affiliated with the team effectively ended his career. The fallout was quick: the orthopedics group immediately ended its two-decade association with the Eagles due to fear of similar litigation in the future, highlighting just how real—and financially catastrophic—these lawsuits can be.

While Maragos’ case involved a professional athlete, its implications resonate deeply in college sports, where the professionalization of athletes through NIL (name, image, and likeness) deals and direct revenue sharing have blurred traditional lines. Team physicians, once seen as trusted partners guiding student-athletes through injuries, are increasingly finding themselves in the crosshairs of a system that now places a financial value on each and every game missed—and every medical decision made.

The Franklin Dispute: A Warning Sign

Years before the Maragos verdict, former Penn State football team doctor Scott Lynch alleged that head coach James Franklin tried to interfere with medical decisions. Though an internal review stopped short of concluding Franklin violated NCAA bylaws, Lynch ultimately won $5.25 million for wrongful termination from the hospital that employed him. Even then, the underlying tension was clear: coaches, whose livelihoods depend on athlete availability, may seek to influence doctors—putting physicians in a precarious ethical and legal position.

A Growing and Widespread Issue

In today’s college sports landscape, six- and seven-figure NIL deals are common, and schools themselves will soon directly share millions with players. The stakes have never been higher. For team physicians, this means not only treating injuries but also accounting for the financial consequences of every medical call.

Dr. Jon Divine, Cincinnati’s head team physician, shared that he’s now ordering more MRIs than at any point in his 25-year career—partly out of caution, but largely to protect both himself and the university from claims that an injury wasn’t thoroughly evaluated. Across the Big 12, doctors and general counsels are even considering higher liability insurance limits—$2 million, $6 million, or more—to cover the rising potential damages if an athlete sues over lost earnings.

Ongoing Lawsuits: From the Catastrophic to the Hypothetical

Consider the recent lawsuit filed by Greg Brooks Jr. against LSU and its doctors, in which Brooks—who had emergency surgery to remove an undiagnosed brain tumor—alleges negligence in his treatment. LSU team doctors initially became aware of his symptoms in August 2023 but delayed surgery until his ailments progressed—with the emergency surgery ultimately leaving Brooks fighting paralysis and speech problems, never to play football again. Cases like this, rooted in severe and life-altering medical events, underscore how high the stakes have become.

But it may not stop there. Imagine a less dramatic scenario: a wide receiver suffers a mild hamstring tweak. Eager to return to the field and maintain his NIL value, he plays earlier than ideal and reinjures himself. Later, the athlete argues that the team's medical staff mismanaged the recovery, hurting his performance, diminishing his NIL opportunities, or costing him a transfer to a higher-profile program. What once might have been dismissed as “bad luck” could now become the basis for litigation.

A Shifting Doctor-Athlete Relationship

Veteran team doctors like Dr. David McAllister at UCLA have observed a clear evolution. Where once physicians and athletes developed years-long relationships grounded in trust—sometimes continuing care long after an athlete graduated—today’s environment can feel more transactional, if not adversarial. Athletes, often surrounded by agents and managers focused on maximizing short-term financial gain, may view doctors less as advocates and more as potential obstacles to earning power.

This fundamental shift is already causing experienced doctors to reconsider their roles. Some are leaving sports medicine entirely, while others weigh the personal and professional costs of continuing in an increasingly litigious, high-stakes environment.

Looking Ahead

The NIL era has brought transformative benefits to college athletes, but it has also introduced complex medical, legal, and ethical challenges that are only starting to surface. As more lawsuits emerge—both catastrophic and relatively minor—universities, athletic departments, and medical staffs must adapt, re-evaluating liability coverage, treatment protocols, and, perhaps most importantly, how to rebuild trust with the very athletes they’re there to protect.

In a system where every injury could carry a price tag, the role of the team doctor has never been more essential—or more exposed.

Sources: Eric Olson, "Team physicians in college sports wary of greater liability risk with athletes now making big money", AP (Jun. 24, 2025).