A quack heard around the world

To the Editor: I note with interest Best's article suggesting that medical involvement in sport and training should not focus only on the elite athlete.1 I agree wholeheartedly with this premise. Best informs us that a sports medicine training facility at Falls Creek would “combine the current medical service and teaching arrangements with a new model for year-round sports training in a ‘clean' environment”.

The Australasian College of Sports Physicians (ACSP) has had a full-time, 4-year advanced training program in sport and exercise medicine since 1992. Sport and exercise medicine is recognised as a medical specialty by the Australian Medical Council (AMC), and the ACSP training program is an AMC-accredited specialist training program. Best's article could easily be interpreted as suggesting that current training in sports medicine lacks ethical content and is confined to the concerns of the elite athlete. The vast majority of patients seen by sport and exercise medicine physicians have no involvement in elite sport, and many would not consider themselves “athletes” in any sense of the word. The practice of sport and exercise medicine focuses on removing obstacles to physical activity for individuals of all ages and exercise capacities.

The ACSP training program has a heavy emphasis on ethical practice, evidence-based nutrition, physical activity as a therapeutic intervention, and antidoping education. While it is true that ACSP Fellows are strongly represented in sports medicine leadership positions in Australia and New Zealand, most ACSP Fellows (> 80%) draw no significant revenue stream from high-performance (elite) sport.