Allegations of sexual abuse carried out over decades by team physicians at Michigan State and Ohio State are sending ripples through university athletics departments, with some schools exploring whether more oversight is needed for figures in such powerful positions.
The scandals involving former Michigan State team doctor Larry Nassar, who was also a physician for USA Gymnastics, and Richard Strauss, a former Ohio State doctor, reveal how the trust and intimacy granted to team physicians can also provide cover for sexual predators.
"It's almost this god figure that people don't want to question," said Dani Moffit, who leads a master's program in athletic training at Idaho State University and researches sexual harassment in college sports. "They are thought to be these people who are not going to make mistakes."
Groups that represent team doctors say it's hardly the only profession shaken by sex scandals, and they largely blame the recent cases on a couple bad seeds. Still, the fallout has left some doctors and colleges scrutinizing their practices.
Some are ramping up the use of exam chaperones — medical staff who are brought into the room to monitor the doctor's work. Purdue University says it's crafting a new policy requiring chaperones for team doctors, even if students don't request one. Michigan State updated a similar policy last year.
Physicians, too, are increasingly bringing in chaperones for their own protection, said Dr. Chad Asplund, president of the American Medical Society for Sports Medicine. In his work at Georgia Southern University, Asplund said, he has become more diligent about calling for a chaperone any time he examines a female athlete or asks a patient to remove clothing.
"It's safety for the patient and safety for me," Asplund said. "I think people are becoming a lot more protected and a lot more cautious about doing the right thing."
News of the Nassar case prompted leaders at the University of Wisconsin to launch a wide review of their own practices, including safety measures guiding team doctors. Officials declined to share details, saying the study has yet to wrap up.
Athletic trainers, who work alongside team doctors and treat minor injuries, have also been alarmed by the allegations. In the Nassar case, two trainers were reportedly told of Nassar's abuse but failed to stop it.
Moffit, at Idaho State, said she's adding lectures on sexual abuse and is helping other colleges develop their own training, which she says has long been overlooked in a male-dominated field.
"It's something that is going to be talked about a lot more. There's just so much education that has to be done," she said.
The National Athletic Trainers' Association responded by issuing new guidance to members, telling them how to identify abuse. Trainers are also being told to report misconduct to legal authorities first rather than university officials, who in some cases have been accused of keeping accusations quiet.
Some colleges, though, say it's too soon to make changes. At Iowa State University, athletics officials said they're "following the national conversation" to see if updates are needed. Others declined to comment, including the universities of Michigan and Illinois.
Both recent cases have cast light on a role that typically operates behind the scenes but can still carry great power. Decisions made by team doctors can shape an athlete's career, determining how long they'll be out with an injury or whether they're even fit enough to make a team.
That power, coupled with the familiarity they often develop with younger athletes, creates a dynamic that is ripe for abuse, said Dr. Saul Marks, a sports psychiatrist at the University of Toronto.
"Athletes are especially vulnerable at this age. They're looking for guidance and growth, and so the intensity in the relationships can be stronger," said Marks, who has also served as a doctor for Canada's national diving team. "As people become closer, boundary crossings can become easier to slide into without realizing what's happening."
When abuse does occur, the risk tied to reporting it is often enough to silence victims whose athletic careers hang in the balance, said Sue Ann Van Dermyden, the head of a California law firm that helps colleges investigate sexual misconduct.
"They recognize by bringing it forward, their dreams could be shattered," she said.
In April, a state investigation in Michigan found that Nassar twisted the power and privacy of his job for abuse. Over time, he convinced gymnasts that his vaginal "treatments" had a medical purpose. And with no chaperone policy, there was often no one there to question it.
Details at Ohio State are still emerging. An outside firm has been hired to investigate complaints against Strauss, who was a team doctor in the 1980s and '90s and died in 2005. The school says men from 14 varsity sports have brought allegations of sexual misconduct, but officials have declined to elaborate.
An Associated Press review of Ohio State employment records also revealed that Strauss worked at five other universities, including Harvard and Rutgers universities. Most of them would not say if they are reviewing his time there or whether any concerns were raised about him.
Asplund, at Georgia Southern, said both cases appear to stem from physicians who became too powerful within their institutions, but he doesn't see it as a sign of deeper problems in the industry.
"The Nassar cause and the Strauss case were unfortunate, but they were outliers," he said. "I hope we don't hear about anything more."
