by  Billy Witz| The New York Times | published February 16, 2025

Early in the 2014 football season, a Nike representative entered the Penn State athletic trainer’s office and confronted the football team’s two doctors and head trainer.

The representative ran down a list of players, including the star quarterback, whose socks and shoes had recently been taped over to help stabilize previous injuries. The tape covered the Nike swoosh, and the representative wanted it stopped, court testimony showed.

Soon, the coach, James Franklin, began to interfere, requiring the trainer to provide a list of players who needed their ankles taped over their shoes, along with an explanation. The episode was just one instance that troubled Scott Lynch, the head team doctor, who had begun to feel that in the face of pressure from the coach and administrators, he was the only line of defense for the athletes. He complained to supervisors about the coach’s meddling with medical decisions. Ultimately, Dr. Lynch was removed from his position. Then he sued.

Last year a Pennsylvania jury awarded Dr. Lynch $5.25 million in damages for wrongful termination. The trial offered a rare glimpse into how a high-profile college football team handled decisions around injuries — and revealed the pressure on trainers and doctors to greenlight students to get back on the field, despite reservations.

“College sports are broken, and I think they’re beyond repair,” Dr. Lynch said in an interview. “There’s way too much money that’s getting in the way of people making good decisions. Nobody’s protecting the athletes.”

College sports will even more closely resemble professional leagues later this year if the terms of an of an antitrust lawsuit settlement are approved, compelling schools to pay athletes.  But unlike college athletes, professionals are represented by labor unions and have more autonomy over their medical decisions.

The examples from Dr. Lynch’s lawsuit date between 2015 to 2019. But there are signs that concerns still exist at Penn State and beyond.

In 2022, Penn State football players themselves expressed concern around medical care, but their attempt to organize — including a request for a third-party representative on medical decisions — was opposed by the school and the Big Ten Conference and went nowhere.

In October, a Louisiana State player sued the school, saying that a coach had told him he could lose his starting spot after having complained of headaches. He was diagnosed weeks later with a brain tumor. The family of a Bucknell player who died during a workout last summer says the school has not been forthcoming about what happened to their son.

In a statement, L.S.U. said its health care contractor provides exceptional medical care for its athletes, but otherwise declined to comment. Bucknell said in a statement that it plans to share more information with the player’s family once it is further along in its investigation.

‘The Wild West’

A 2019 survey by the National Athletic Trainers’ Association hinted at the scope of the problem: Nearly one-fourth of the 1,800 respondents said that they did not have medical autonomy, and more than one-third said that coaches had influence on the hiring and firing of medical staff. Nearly one in five reported a coach playing an athlete who had not been medically cleared.

A year before Dr. Lynch was removed at Penn State, Moira Novak was ousted as the director of athletic medicine at the University of Minnesota; she says she was viewed as an obstacle to winning when she reported what she had viewed as unethical — or illegal — behavior.

“College athletics is the Wild West when it comes to medical services,” Ms. Novak said in an interview. “I’m sure there’s some that do a decent job. But if I had a son or daughter who was a college athlete, I’d make sure they know they have to be their own advocate.”

Penn State said in a statement that it was “extremely disappointed” in the jury’s verdict. The statement added that athletes participate only with the independent approval of the athletic department’s medical team and that Mr. Franklin did not influence athletes’ medical care. “Throughout James Franklin’s tenure, he has worked tirelessly to build a program focused on the well-being of student-athletes,” the statement said.

Defense attorneys portrayed Mr. Franklin’s questioning of medical decisions as the routine seeking of information.

Mr. Franklin, who has seven seasons remaining on a 10-year, $85 million contract, declined an interview request through an athletic department spokeswoman, and he is not a party in the lawsuit. The coach and Penn State were dropped as defendants because of a missed filing deadline, a ruling Dr. Lynch is appealing. His former employer, Hershey Medical Center, which is owned by Penn State University Health, and his former supervisor, Dr. Kevin Black, are appealing the verdict.

But the judge in the case, Andrew Dowling, wrote a recent opinion urging that the appeal by the defendants be denied because they had “prioritized their interest of protecting the Penn State Football team and Mr. Franklin rather than the health, safety and welfare of the football players.”

During the trial, the jury heard nearly a dozen stories, many corroborated, from Dr. Lynch about what he saw firsthand as the head orthopedic surgeon for the Penn State athletic department and football team doctor.

The jury heard that Mr. Franklin had pressured Dr. Lynch to allow the former star running back Saquon Barkley, who had missed the previous game with a sprained ankle, to return without passing recovery protocols; urged Dr. Lynch to withhold information from a player with a knee injury so that he might return quickly; and suggested hanging a sign in the trainer’s room that read “the lazy, overweight, unmotivated and injured football player look the same.”

When Mr. Franklin yelled at him, ignored him or hung up on him, Dr. Lynch held his ground — until he was removed from his job in 2019.

Dr. Black told him the reason was because he was not a full-time resident of State College, Pa., but Dr. Lynch owned a condominium downtown. He did not have full operating privileges at Mount Nittany Medical Center in State College but did at Hershey Medical Center, a renowned hospital with specialists who were rare at Mount Nittany.

Rob Windsor, a former defensive lineman who finished his career at Penn State and played briefly in the N.F.L., testified that during his senior season in 2019 a new head trainer, whose predecessor had been forced out, had ignored his repeated requests to meet with Dr. Lynch to discuss a knee injury.

“You had a doctor and a trainer that were standing up for the athletes, and they got rid of them both,” said Mr. Windsor, who like several others who testified said they felt conflicted about speaking out against Penn State because of their affinity for the school.

‘Put up or shut up, or leave’

The N.C.A.A. was founded in 1906 at the behest of President Theodore Roosevelt after a surge of deaths among college football players the previous season. The association’s guiding principle: keep athletes safe.

More than a century later, as college athletics became a billion-dollar business, the N.C.A.A. attempted to rein in coaches and athletic directors who were interfering with medical care. In 2017, the association made a policy change, requiring team doctors and trainers to have “unchallengable autonomous authority.” This included keeping athletic directors and coaches out of hiring and firing decisions.

The N.C.A.A. amended its bylaws last year to require schools to conduct an annual review of these policies.

“The failure is, there are no reporting mechanisms and there’s no enforcement,” Brant Berkstresser, the chair of the N.A.T.A.’s council on intercollegiate athletics, said. “A standard without a consequence is not a standard.”

The N.C.A.A. has never punished a school for interfering with medical autonomy, according to the association’s infractions database. An N.C.A.A. spokeswoman declined to comment.

Ms. Novak, who worked from 1998 to 2017 at the University of Minnesota, said she encountered a culture averse to her efforts to protect athletes.

In a memorandum to the university’s Board of Regents in 2018, obtained by The New York Times, Ms. Novak detailed alleged abuses that included a coach urging an athlete who had dizziness and blurred vision following a car crash to withhold that information. The medical team became aware of it only when the athlete was hospitalized after collapsing.

The University of Minnesota said in a statement that return-to-play decisions are made by medical staff and the athlete, that coaches and administrators are not involved.
Ms. Novak considered a lawsuit, but she reached a settlement with the university. When she was pushed out, “it was a very strong message to the remaining staff: Put up or shut up, or leave,” she said.

Dr. Lynch’s case took five years to go to trial, survived repeated attempts to dismiss and was narrowed to exclude Mr. Franklin; Sandy Barbour, the athletic director at the time; and Penn State. Also disallowed was the university’s internal investigation, which was conducted by the athletics integrity officer at the time, Robert A. Boland, in collaboration with the university’s general counsel. This permitted Penn State to shield the report’s findings from scrutiny by asserting attorney-client privilege.

The 15-page report, a copy of which was obtained by The Times, questions Penn State’s rationale for removing Dr. Lynch but makes no conclusions.

The jury returned a verdict in a little over two hours, on Dr. Lynch’s 63rd birthday. He hopes the outcome prompts reforms that prioritize athletes’ health.

Steven Marino, Dr. Lynch’s attorney, was not so sanguine.

“It was a devastating finding of fact, but I don’t think it’s enough to effect change,” Mr. Marino said. “It should have been a $50 million judgment. This is just going to be the cost of doing business.”

Adam Bednar contributed reporting.

A version of this article appears in print on Feb. 16, 2025, Section A, Page 30 of the New York edition with the headline: The Power Struggle Over College Athletes’ Well-Being. Subscribe

MORE COVERAGE:

> Pennlive’s John Luciew interview with Dr. Scott Lynch and Steven F. Marino, Esquire posting winning a stunning $5.25 million verdict over Penn State

> Penn State player’s medical malpractice suit exposed doctor’s shortcomings, ex-athletic director says

> Meeting with James Franklin preceded team doctor’s firing, supervisor says

> Top 10 moments (so far) from fired Penn State football doctor’s trial

> Emails detail deteriorating relationship between James Franklin, fired football doctor

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