Choosing a medical provider is a very personal decision, and there are many options for athletes, including traditional family practice and specialist physicians, alternative and wellness practitioners, and various telehealth options. However, there are some clinics and health providers that operate outside of state licensing regulations or offer unproven treatments. Some of these treatments involve substances and methods prohibited in sport, such as hormone replacement therapies, growth factors, peptides, and IV therapies.
Read below to learn about some things to consider when choosing health care as an athlete subject to anti-doping rules.
Use licensed, board-certified physicians
Athletes prescribed medications or treatments that are prohibited in sport will need to apply for a Therapeutic Use Exemption (TUE) for permission to use the medication or treatment. Under the World Anti-Doping Agency (WADA) TUE Guidelines, detailed documentation from appropriately credentialed board-certified physicians is required for a TUE to be granted.
For most routine and specialty medical care, USADA recommends athletes receive care from providers with active licenses from their state who are also in good standing with their medical boards, including licensed physicians (Medical Doctors or MDs), Doctors of Osteopathic Medicine (DOs), Physician’s Assistants (PAs), or Nurse Practitioner (NPs).
You can look up medical providers on their states’ medical boards; every state has an online database that shows license status, discipline, and sometimes specialty. You can verify that the clinic address and name you’re visiting match what’s listed on the license and that the license is active (not suspended or restricted). Many insurance companies also have specific search engines to find licensed medical providers.
Taking risks, such as not verifying the status of your medical provider, could result in being misdiagnosed, receiving treatment that is ineffective, or receiving treatment that causes a positive test or adverse health effects.
Remember Prohibited Association
USADA also maintains a list of Athlete Support Persons (ASP) who are currently serving sanctions, including medical providers. Keep in mind that the Prohibited Association rule prohibits both athletes and athlete support personnel from associating with any ineligible individual serving as an athlete support person who is serving a doping sanction. Separately, any current SafeSport violations can be found on the SafeSport website.
Alternative Health Care, Wellness Clinics, and Telehealth
For athletes, there are many factors to consider when it comes to alternative health care providers, wellness clinics, or online telehealth providers. Below is a table of ideal and red flag medical care situations, and these comparisons are designed to help athletes evaluate and weigh their health care options.
And while we’ve identified ideal medical situations for athletes below, the unfortunate reality is that not all athletes will have access to these resources. If athletes find themselves faced with a red flag situation, more questioning and/or evaluation of the clinic or provider may help them find ways to reduce that risk.
| Ideal Situation for Athletes | Red Flag Situation |
| The clinic is run by one or more physicians who are on-site on a regular basis | The clinic is affiliated with a physician that is not on site, or whose role is to review cases remotely |
| The physicians on-site meet with the patients in-person, or speak directly with patients over a telehealth platform | Patients never see or speak directly to a physician, and are only treated by other staff within the clinic |
| The assessment and diagnosis are thorough and involve taking a detailed health history and carrying out clinical tests | Assessment and diagnosis are quick or non-existent, with little clinical workup or testing |
| Various FDA approved treatment options are discussed with the patient, along with the risks and benefits of each | There is minimal or no discussion of FDA-approved treatments. Rather the clinic or provider focuses on their “special formula,” or they sell a single treatment to many patients |
| The clinic prescribes FDA approved medications or treatments | The clinic prescribes their own versions of popular name brand drugs and promises lower costs, or they try to sign patients up for a monthly subscription to a service. |
| The provider is willing and able to identify treatments and medications that are not prohibited by WADA | The clinic or provider offers only treatments or medications that are prohibited by WADA, and/or are not willing or interested to learn about anti-doping rules for athlete-patients |
| If prescribed a compounded drug, the patient is given specific details as to why the FDA-approved version is not an option | Clinic regularly prescribes “research chemicals” and/or compounded versions of FDA-approved drugs for patients without a clinic need, claiming lower costs or fewer side effects (such as “generic GLP-1s”) |
| The clinic is part of at least one (or more) insurance networks | The clinic only accepts cash or cryptocurrencies |
The FBI has specifically warned about clinics and medical spas selling “fraudulently compounded” versions of weight loss drugs (for example, products that claimed to contain semaglutide but actually contained other ingredients or high levels of unknown impurities).
Takeaway
In conclusion, the majority of athlete health care should be provided by a licensed MD, DO, or Physician’s Assistant (PA) or Nurse Practitioner (NP) in an office. Similarly, you cannot always trust a clinic just because it seems like a clean facility with professional marketing. Also, athletes should not get medical information solely from social media; biased claims and AI-generated content that promotes quick fixes and the failures of conventional therapies should be a red flag. Always do your due diligence to make sure you are receiving evidence-based care from a licensed provider.
Questions?
For questions about specific products, substances, and methods, contact USADA’s Drug Reference Line at DrugReference@USADA.org or call (719) 785-2000, option 2.
References:
Safety Concerns Related to Fraudulent Compounding Practices Associated with Weight Loss Drugs. Public Service Announcement February 28, 2025. Federal Bureau of Investigation.
Sellers S, Utian WH. Pharmacy compounding primer for physicians: prescriber beware. Drugs. 2012 Nov 12;72(16):2043-50.
