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Howard Petroff, an alumnus of the University of Toronto’s Faculty of Medicine, is a family medicine practitioner, a lecturer in the department of family and community medicine, and serves as assistant medical director for the Toronto Raptors basketball team. 

Writer Suzanne Bowness asked him about his experiences in family and emergency medicine, his work with the Raptors and the challenges of working with high-performance athletes.

“It’s a demanding and challenging life that these individuals face – and not just the players, but the coaches, too,” says Petroff. 

“It sounds glamorous, but it’s a lot of work.”

You’re a full-time practitioner in family medicine and for years were a part-time emergency medicine doctor. What do you like about each and how does working in one inform the other?

In family medicine, I enjoy the relationships that you develop over time. Some patients who I saw as infants are now having children, so I’m seeing the whole circle. Building those long-term relationships is really rewarding, seeing them when they’re celebrating milestones and helping them when they’re going through difficult times.

Emergency medicine is a different experience. You have to really enjoy the fast pace and helping to deal with acute problems. I also enjoyed the camaraderie in the emergency department. I was fortunate to work in a hospital where the emerg was very well-supported, my ER colleagues were excellent clinicians and where the director was an excellent leader.

I was able to bring my family medicine perspective to that of my colleagues who worked full-time in emergency – the experience of how we practise and the importance of a strong relationship between the two areas. Seeing patients in emerg helped me to recognize and deal with acute issues in my office. They came together very nicely.

You’re in your 15^th season as a doctor for the Toronto Raptors basketball team. What does that involve? Are you a fan?

It’s something that came about in a circuitous manner as I’m not a sports medicine physician. I bring the perspective of general medicine to the medical staff, looking after the primary medical care and emergency preparations. We’re a medical team of two physicians: myself and our head physician, who is an orthopedic surgeon and a sports medicine physician. And we work with a director of sports science, athletic therapists, a physiotherapist and a massage therapist. We also have a team dentist and various consultants who assist us. I co-ordinate the players’ annual physical examinations, clinical and cardiovascular testing, medical clearance for players, and consult with our specialists as needed.

You meet a lot of very interesting people from a wide variety of backgrounds. It provides you with a different perspective on professional sports and the high demands, expectations and challenges that individual players face. My role is to look out for the players’ health and I pride myself on trying to ensure the highest quality of care. I also help co-ordinate care for their family members because the majority of them are from out of country and don’t have their own personal network locally.

Before my involvement with the team, I would watch games on a casual basis but I’ve become a basketball fan. When I was first approached to help out, I didn’t know all of our players or the intricacies of the game. I definitely have learned over time. I’m at the majority of home games.

What’s it like working with high-performance athletes compared with regular patients?

With athletes, timelines are obviously more compressed due to the season, and co-ordination of care can be difficult because of challenges with scheduling and travel. But with injuries and the healing process, things still take time to resolve.

While our athletes are young and healthy, they’re not your typical 5-foot-10, 170-pound individuals. Many players are 6-foot-6 or taller, so their anatomy sometimes presents challenges. For instance, because a lot of test parameters are based on the general population, assessing things such as cardiovascular risk can be difficult. The NBA has been collecting data on player parameters, including cardiac measurements, so we now have points of comparison relevant to the physical stature of our players.

You also see the physical and emotional pressures players face because of the high-performance expectations. The physical demand of playing three times per week with practices interspersed between, the impact of an extensive travel schedule and disrupted sleep, and time apart from family and personal supports, can all affect performance. It’s a demanding and challenging life that these individuals face – and not just the players, but the coaches, too. It sounds glamorous, but it’s a lot of work.

What advice would you have for current medical students?

I think you have to remember why you went into medical school, which is really to help people. You can’t stray from that. It isn’t a 9 to 5  job. You have to be available, you have to be open to conversations, to be able to talk to people and maintain good relationships.

It's very demanding. But it’s also very rewarding when you’re invited to a milestone birthday party or when a patient says “thank you.” People may disagree with you, and you have to accept that, but try to do things with integrity and professionalism and you'll find it to be a very rewarding career.

Finally, it’s important to find mentors and role models. People who can help supervise and guide you to help you achieve your professional goals. I’ve been very fortunate to be exposed to excellent clinicians who were wonderful individuals. That really helped me.