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Is There a Doctor in the House?

For 20 years, primary care and sports medicine physician David E.J. Bazzo, MD, has provided care for a unique team: the San Diego Symphony.

By Heather Buschman, PhD   |   August 26, 2019

​David E.J. Bazzo, MD, was in his primary care and sports medicine clinic at UC San Diego Health one day in 1999 when his receptionist received an unusual phone call. It was from the San Diego Symphony, asking if a doctor might be available to cover their shows.

He leapt at the chance to act as the group’s “house doctor,” and has been doing it ever since.

“I was already a symphony fan, so it was pure serendipity that this wonderful opportunity came about,” said Bazzo, who also serves as president-elect of the California Academy of Family Physicians, head team physician for the San Diego Seals lacrosse team and immediate past-president of the San Diego County Medical Society.

San Diego Symphony

San Diego Symphony at Copley Symphony Hall. Image by David Hartig

As the Symphony’s house doctor, Bazzo coordinates coverage by physicians to help patrons in need. He and his colleagues are on hand to provide first aid and expert advice for any medical situation that might arise.

On any given night, he might attend to a symphony-goer with a stomach flu, an elderly person feeling faint or someone who has fallen. In one memorable instance, an attendee suffered a minor eye injury due to ash from the fireworks display that concludes each summer symphony performance at Embarcadero Marina Park South. In the early 2000s, Bazzo helped the symphony raise money for and install automated external defibrillators to improve patron safety in the event of a cardiac arrest.

“The long-term house physician program and partnership with UC San Diego Health has been an invaluable benefit to the San Diego Symphony organization, and to our employees, volunteers and patrons,” said George Kutchins, front-of-house manager for the San Diego Symphony. “Over the past 20-plus years under Dr. Bazzo’s leadership, the house physicians who have participated in the program have brought a high level of professional excellence, compassion, public engagement and continuity to efficiently and effectively address the diverse health care needs that may unexpectedly occur at the thousands of concerts and events at our various venues. We greatly value their strong commitment and look forward to continuing this very successful partnership and indispensable program.”

Over the years, Bazzo has also provided medical care for out-of-town guest musicians, conductors and crew members while they visit for a night, or for months, with the symphony. Musicians can have unique injuries and medical needs, he said. They may experience wrist and finger tendonitis after years of playing string instruments. Wind instruments often cause thumb strains. Drummers can experience stress fractures and heat-related illnesses. He once treated a brass musician (not with the symphony) who developed a fungal infection due to the near-constant presence of saliva on his lips.

According to Bazzo, approximately 75 percent of orchestral musicians will develop one or more injuries during their careers, most commonly overuse injuries due to the physical demands of the job. And since most instruments only come in one size, that size might not be ergonomically well suited to some musicians, depending on their height, weight and arm length.

“These musicians are like athletes,” he said. “They have to warm up, stretch and strengthen. If they’re injured, they need proper rehab and sometimes steroid injections, braces or surgery.”

Also like many athletes, injured musicians can experience anxiety about the likelihood of full recovery or ability to continue to play long-term. Elite musicians can suffer from burnout, with symptoms like emotional and physical exhaustion, feelings of detachment and loss of enjoyment. Burnout can lead to depression, substance abuse, trouble with relationships and overall poor health.

“Music is the intersection of physical, intellectual, emotional and creative efforts,” Bazzo said, “So for optimal performance, more needs to be treated than just muscles and ligaments.”

Bazzo and his trainees also regularly council UC San Diego’s performance artists on how to prevent overuse injuries and burnout. Their advice includes:

  • Recognize the early symptoms of overuse: pain, loss of range of motion, loss of endurance, loss of fine motor control
  • Modify your technique or instrument, if appropriate
  • Warm up the entire body, as well as the injured part, prior to playing
  • Cool down gradually after playing
  • Consider ice therapy and over-the-counter anti-inflammatory medications for a new or temporary injury (but not for a chronic condition)
  • Try biofeedback or stress reduction training to relax, reduce stress and correct excessive muscle tension
  • Be aware of emotional stresses, and seek help when necessary
  • Practice good nutrition habits — don’t play hungry, stay hydrated
  • Return to full play gradually after an injury
  • Develop a relationship with a health care provider experienced in working with performance artists

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