Last month, Dr. John York, who is co-chairman and owner of the San Francisco 49ers, led a panel that discussed safety issues in the National Football League at the Commonwealth Club of California. The panel included Brent Eastman, chief Medical officer and corporate sr. vice president at Scripps Health in La Jolla, Calif, and Dan Fouts, a member of the Pro Football Hall of Fame. Here’s the transcript of this panel:

In response to Dan Fouts talking about the safety stickers on the back of helmets saying not to use your helmet to tackle an opposing player:

Dr. John York: Actually, Dan, you’re taught now not to do that and you can be penalized for that.

Fouts: Absolutely. I think it’s a great rule, and it’s starting to take effect.

York: In fact about the time that you (Fouts) were entering your career, you know that the competition committee has been around forever. Rich McKay, who’s been the chairman of the competition committee for at least 20 years, is the President of the Atlanta Falcons and who was the President of the Tampa Bay Buccaneers. When he first started as a member of the competition committee, the rules were all geared toward making the game a better game. Over the years, today 80 to 85 percent of every rule change has to do with player health and safety, which was not true in 1975.

On how the military and the NFL have been working with each other to exchange knowledge about concussions:

York: Interestingly, the NFL and the DOD (Department of Defense) both recognize that and for the past three years, the two have been working together on helmet sensors. The injuries aren’t exactly the same, but we can learn from each other.

Dr. Eastman & Fouts go through the different injuries that Fouts suffered throughout his career.

Q&A with audience:

On there being a conflict of interest if the physician that a player reports to after an injury is an employee of the team, how the physician balances those responsibilities and is it commonly being addressed by the NFL as an issue:

York: I think that is a very good question. Interestingly, what I’ll do is I will start by saying that I’ve been involved and around the physicians of the San Francisco 49ers since 1978. I don’t know why the 49ers are the way they are, but since 1978, I have never seen a player, who has a relationship with the head team physician or an orthopedic surgeon, that the player’s health and safety didn’t come first and there was no interference from a head coach, the general manager, an owner or anyone else. Now, I am now the chairman of the health and safety committee of the owners and I am frequently reminded by a number of physicians that that’s not the case at all organizations, but we’re getting closer and closer to that.

Paul Tagliabue introduced the idea that health and safety should always come above competition. Roger Goodell has made it even more emphatic and there are lines of communications for players who feel if they are being challenged to do some of the things — even some of the things that Dan’s (Fouts) doing — the idea of a coach asking you with a broken hand to see if you can take a snap? I really am not sure that that would happen today. I know it wouldn’t happen at the 49ers.

On if the Saints just got caught with their bounty program or if it is fairly common in the NFL:

Following Fouts’ answer:

York: Let me add: there actually is, in the NFL bylaws that owners take part in and that coaches and general managers know, there is an anti-bounty clause. Players can be paid for performance — for interceptions, for tackles, for fumble recoveries — but there is express language that outlaws being able to get anything for hurting or knocking a player out of the game. In this particular case, I believe there is evidence to show that if a Saints player hit another player cleanly and the player got up and went back into the huddle, they got no payment. If he went to the sideline, they got paid.

On what can be done to make the game reasonably safe without changing the basic nature and without altering the sport:

York: That is a five hour conversation with no answer at this point (laughing). Just as I made the comment that the competition committee, which is used to work on rules to make the game better, is now 85 percent geared toward health and safety. The injury surveillance — rather it be knees and ankles or rather it be the head, neck and spine group — all of those things are being looked at to make the game safer, whether it be equipment, rules or whatever. The last Collective Bargaining Agreement, the Players Association and the NFL agreed to put $100 million aside for research. The NFL has just put $30 million into the hands of the NIH (National Institute of Health) for them to use in the best way they believe possible to look at head injuries and the prevention of head injuries and trauma with the head.

There’s a lot being done and I don’t think I can give you answers, but we are certainly tasked with making sure that this game is as safe as possible. If it’s not a violent game, it’s not football. I think Dan would attest to that, but it can be made safer through equipment changes; changes to helmets; the way we measure things; rules about when somebody is concussed and when they can return; all of those things.

–NFL media services