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Each year at Baseball Prospectus, we give out the Dick Martin Award for the best medical staff. The Award is based on several objective factors, and is designed to bring attention to one of the least noticed but most valuable parts of a winning baseball operation. While all 30 teams’ units work long hours for a fraction of the pay that their charges make and are well qualified, working their way up through the minors in the same way as players, only one of these 30 can win the Award. This year, the value brought by the winning staff is clear, because in addition to this Award, they have a couple pennants and a ring.

In the past, DMA winners have been something of a leading indicator, with teams like the Brewers and Rays making playoff runs behind excellent health and improving young teams. This year, Scott Sheridan’s Phillies win the Dick Martin Award after a second straight World Series appearance. The health of the team and, just as important, the management of the injuries they did have helped the Phillies get to baseball’s pinnacle in both seasons. Facing challenges like their star player having an untested surgery, keeping a struggling pitcher healthy enough to stay on the mound, monitoring the workload of their young ace, and integrating new players with their own injury histories, the Phillies kept their team on the field and productive throughout the 2009 season.

Of course, this isn’t a fluke. The Phillies three-year and five-year averages for both days and dollars lost to the DL are among the many reasons this team is taking home the trophy this season. In just the third year after taking over from long-time trainer Jeff Cooper, Sheridan’s staff is a relatively new one, but it’s already considered one of the best in the business. Sheridan was able to hold on to the rehab successes that Cooper’s reputation was built on while focusing on prevention and injury management.


Bucking the Phillies

As Sean Engelhardt’s graphic so clearly shows, the Phillies are doing more than keeping players healthy-they’re saving their team and adding wins and dollars to the bottom line. In fact, for many teams, it could be the difference between making the playoffs or not. While MLB has thrown over a billion dollars away on just injured pitchers alone over the last five years, almost nothing has been done to assist the overworked and undercompensated medical staffs. Budgets haven’t changed. Few teams have more than three people on staff. Players continue to be far-flung and self-directed in the offseason.

It’s a challenge that Scott Sheridan, Dr. Michael Ciccotti, Mark Anderson, and Dong Lien face every day. It’s also one that, in 2009, they did better than any other team. Congratulations to the 2009 Philadelphia Phillies‘ medical staff on this Award from all of us here at Baseball Prospectus. It might be a small thing next to the two pennants and that World Series ring they won, but they understand that it’s a part of those as well.

Thank you for reading

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Asinwreck
11/13
Will, can you explain how Sean Englehardt's chart relates to the criteria you use to select the award? I ask, because the measures he includes appear to show the White Sox leading in days lost to injury and percentage of salary lost to injury; other teams, including the Cardinals, Brewers, and Marlins, lead the Phillies in one category or another. How does the visual display of this data enhance your argument that the Phillies had the most successful medical staff?
airlifting
11/13
I can only venture a guess that it has everything to do with their success. The Cards were arguably just as successful by making the playoffs, but the difference in days lost is pretty marginal. Every other team at the top before we get to the Yankees, obviously, has little to no actualy success in 2009.

But if the argument is who kept their team the healthiest, I have no idea how Herm Schneider and the White Sox don't win this "award."
wcarroll
11/14
The award also has a three- and five-year average component to it. After we look at those five numbers, I sit down with six of my top medical advisors and see if we can come to a consensus, which was relatively easy this year. Schneider and the Sox got major consideration, no surprise since they won a couple years ago.
DrDave
11/14
Thanks for the clarification, Will.

I assume that the Royals have to come out near the bottom of your rankings, even though they're in the middle of the days/dollars chart. Where do their particular kind of failings fit into your evaluation process?
wcarroll
11/14
We just talk about the potential winners. It really came down to the Phillies, Cards and Sox this year. All would have been deserving winners, but the Cards were hurt by their 3-yr avg, which was in large part the loss of pitchers. They take on a lot of risk, so if there was some sort of risk-adjustment that would be consistent and valid, they'd get a lot of points there.
Oleoay
11/14
Which teams have been trending better over their last three years, but perhaps have a poorer five year trend?
wcarroll
11/14
Good question ... maybe I can get Sean to do another of his cool-as-heck graphs on that.
Oleoay
11/15
That would be great. It'd be interesting to see which teams have gotten better or worse over the last three years and have a chance of improving or lowering their ranking.. and perhaps, from such a list, factors can be identified that show what good teams do well and poor teams do poorly etc.
yekkel
11/13
Will, do your considerations in deciding the DMA recipient take into account the relative fragility of the players on each team (though age, injury history, etc.)? If so, how?

BTW, your post on the spitball was fantastic.
wcarroll
11/14
No, there's no consistent method to do so. We do a bit in subjective portion of the award, but really, while days and dollars lost aren't perfect, they are consistent and measureable.
BeplerP
11/13
This confirms suspicions that the Mets have the least competent medical staff in MLB. So- another lost season. The club needs to deal with this or they will repeat their recent history. And Omar will be out of a job. And some great players- Reyes, Wright, Beltran- will have blighted careers. Sad.
ScottBehson
11/13
Just curious, Will and fellow BP readers- What percentage of team health is attributable to the medical staff, to the players and to luck?
Oleoay
11/13
Well, the Yankees days and dollars lost are mostly due to Rodriguez and Wang, both of whom were injured before the season started. So there's a bit of luck with that, especially in the dollars column.

Also, since the Yankees have a high overall payroll in general and thus, have a lot of players making a lot of money, even one injury could hurt their standing on this chart.
wcarroll
11/14
That's a great question. Is Wang "luck" or "staff", since RB used him as an example. Wang broke his foot running the bases, so I think we'd call that luck. Then he had problems with his hip and shoulder post-injury, which I think we'd have to look at more on the staff. That shows just how hard it is to say whether something's "preventable" or not.
Arrian
11/16
The original injury to Wang, a lisfranc (sp?) sprain, was a total fluke. His rehab, however, may have been botched. Hard to say. Bruney had the same injury and came back. He didn't pitch particularly well, but he's Brian Bruney, he does that. He did appear healthy, and had his normal velocity. Wang, on the other hand, was missing several MPH and movement and got absolutely hammered. Then he wrecked his shoulder. I have no idea how to grade that, but I was pretty pissed off at the Yankees training staff at the time.
llewdor
11/13
That's an entertaining chart. Note how Toronto is below the median in days lost, but lost only a tiny portion of their payroll - presumably because they kept injuring young pitchers earning the minimum.
irablum
11/13
I hate to argue with your award, but based on the above chart, I'd have given the award to the Cardinals. Any team with Chris Carpenter on it coming off shoulder surgery shouldn't have been that healthy. Grats Cards.
brownsugar
11/14
How does Carpenter having the shoulder injury in the first place *enhance* the Cards' case to win this award? Getting a player back to form after an injury is great work. Keeping the injury from happening in the first place would be even better.
BillJohnson
11/15
I'd like to hear Ira's answer to this, but my own would be that Carpenter's shoulder was fragile as glass long before he became a Cardinal. He's Exhibit A in Will's remark about the Cardinals being willing to take medical risks. (There are numerous others.)
brownsugar
11/15
Bill, I agree with everything you say...I just don't see how it changes the conclusion any. The Cardinals signed Carpenter to a 5-year contract, and 2 of the first 3 years have been lost to injury. While recognizing that the Cardinals may be willing to sign riskier players, I can't see how one healthy year out of three can be classified as the risk paying off in Carpenter's case.

I don't see how the Carpenter data point can be counted as a success, unless you start counting his data point at April 2009. And as Will made clear in the article, 3-year and 5-year averages are a factor.
Oleoay
11/15
Along those lines, should team physicians be held accountable for giving wrong evaluations of a player's medical history and physical when a team signs or trades for that player?
ScottBehson
11/13
Here's somthing interesting- 162 game season, 25-man roster.
If all players are hurt all year, that's 4050 days lost due to injury. The Mets total of 1415 days lost equals 38% of this total.
Amazin'
jayman4
11/13
Is there a way to see this trended? I have seen random comments regarding the Padres from Will, or so I vaguely recollect, and they were complimentary, so seeing them at the bottom makes me wonder:
a) am I mis-remembering this and the Pads are actually bad
b) or is this pretty random

The Padres have been bottom feeding on pitching, and one fo the reasons pitchers are at the bottom is health issues (mark prior, shawn hill, etc). It would be great to see "expected" injuries vs. actual.
ScottBehson
11/13
Second that. A comparison between some metric of expected time lost due to injury compared to actual would be awesome (probably impossible to cobble together, but awesome nonetheless).
Oleoay
11/13
I also wonder if a person who is on Tommy John or is otherwise out for a year and a half counts against both years.

I'd be interested in seeing how many times a team put a player on the DL
wcarroll
11/14
We do days in-year. Take, for instance, Pat Neshek. Out part of last yr, all of this yr. Counts on both at the time. Things like this are one of those things that would be nice to do retro-actively, but simply can't be. Where do you count someone like Wang?
Oleoay
11/15
The context behind the question was that I was interested in seeing what percentage of players on a team's roster don't hit the DL all year, and what percentage of players on a team's roster make multiple trips. That kind of data could be gathered to analyze injury prevention and injury reoccurrence.

In a case like Wang, he only went off the DL once briefly I believe, though it can also be argued that he had multiple cascading injuries which could have been prevented, and thus, counts against the Yankees staff... but to get that kind of data on each injured player would take a lot of article sifting and probably isn't practical.

How does the process account for misdiagnosis? Qualitatively through the review between you and your medical advisors?
wcarroll
11/14
Expected is too subjective, at this point. While I have a system that does this, it's hardly PECOTA-accurate. I think what would be a better measure is consistency. There are teams like the White Sox and Brewers that have been in the top ten virtually every year we've done this, while a team like the Pads have been up and down. I wouldn't say that means a staff is "good" or "bad" but there's value in consistency.
Oleoay
11/14
It'd be interesting to see if there are certain technologies or techniques that have allowed some teams to do consistently better than others. I mean, each team has a doctor with a degree and I imagine they go to sports physician conferences and ethically would trade techniques, so what factors make some teams consistently better than others.
wcarroll
11/14
Impossible. There's far too many factors, too many individual differences to do that.

Share? You're joking, right?
Oleoay
11/15
Are there really? Earlier in the year was the introduction of TRIP, or Textbook Rehab in Progress... do some teams do things different than the textbook rehab that yield better results, even if it's an hour of whirlpool time?

I thought the team doctors might share info about how to treat injuries because of the Hippocratic oath... but I guess that's hypocritical. :)
hessshaun
11/16
Interesting. If you can get Sheridan to do a post award interview, I would be interested in what went on with Lidge. Besides sucking, he all of the sudden needed elbow surgery? We never did hear details on that injury so I don't know if it's something that was more or less exploratory or "routine". Regardless, that atrocity sort of all added up with that news.
wcarroll
11/16
Torn flexor tendon. Pretty clear that was hidden as he was struggling. More interesting question is when it happened.
Oleoay
11/17
Do the Phillies still get the award then?

If players don't approach the staff and the staff don't catch/detect through some kind of baseline testing that a player is injured, should that affect their ranking? Would that fall under the qualitative criteria?
hessshaun
11/17
Well here is the interesting part Rich. Charlie and Amaro have both been asked about 10 different ways and 100 different times why this happened. They were both on record saying that if they knew that he had that injury, they would have been more than happy to shut him down for the year. I have a terribly hard time not believing either of them knew anything because I think we all read that his season was one of the worst EVER. I know closing isn't easy, but when you are replacing the worst ever (on a season), there is no place to move but up. They also both stated that they would have been happy to know this before the deadline as well. Of course the next logical question is.....Why wait for him to divulge an injury when he is clearly horrible, injury or not, before making a move? So there is the counter argument. Either way, they are either pleading ignorance in attempts to absolve themselves from looking bad or they are rubbing salt into a wound. It just doesn't make sense. Maybe this is something a player can't feel or within the lines of another typical ailment? I don't know, but that's why I always read this column.

In terms of the award, I don't see how it could change. We can't erase Lidge's innings as much as some of us would like to.
Oleoay
11/18
But the thing that I get confused by is I thought each team does regular, yearly physical exams during spring training including strength baseline testing. I would've thought also that with Lidge's horrible season, someone somewhere would've suggested he have an MRI run. If neither of those two things happened, then it is the fault of the training staff.

Now, let's say the trainers did find something and Charlie/Amaro decided to keep it quiet and make him play through it, then the fault lies on management and not the trainers.

I'm not saying Lidge's innings should be erased, but in terms of the award, should the Phillies be docked for not detecting or properly responding to this injury?