The Impact of NIL in Orthopaedic Sports Medicine: A Current Concepts Review.

Background: The rise of Name, Image, and Likeness (NIL) rights has transformed amateur athletics, blurring the lines between high school, collegiate, and professional sports. NIL has introduced unprecedented commercial pressures that extend into sports medicine, where physicians must now navigate new challenges in clinical care, ethics, and liability. Purpose: To review current concepts related to the impact of NIL on sports medicine and to highlight the evolving risks, responsibilities, and roles of physicians caring for athletes in this new landscape. Study Design: Narrative review. Methods: We reviewed newly published articles and analyzed data collected from publicly available databases addressing NIL policy changes, athlete health, and physician practice. Results: NIL has created an environment in which high school and collegiate athletes face pressure to play through injury, pursue premature or unnecessary interventions, and seek multiple medical opinions influenced by commercial interests. Physicians, in turn, face escalating risks, including exposure to litigation for lost athlete earnings, erosion of clinical autonomy, and growing pressure to align care with financial rather than medical priorities. Conclusion: The NIL era requires a redefinition of the physician's role in sports medicine. Providers must balance athlete advocacy with self-protection in a system where clinical decisions now carry increased ethical, legal, and professional consequences.