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Millions, Medicals, and Maybes: The Maddening Art of Assessing Player Health

By Zack Scott | March 10, 2025 at 11:58pm CDT

Zack Scott, former Mets Acting GM and four-time champion with the Red Sox, empowers sports operations and individuals to win through Four Rings Sports Solutions. He specializes in data-driven strategies and leadership development. His Sports Ops Launchpad helps aspiring sports ops pros break into the industry. Connect with him on LinkedIn here.  Zack will be contributing periodically to MLB Trade Rumors. 

As Florida’s Grapefruit League approaches its halfway point, Yankees and Mets fans are already venting their fury. Prized offseason pitching acquisitions Sean Manaea and Frankie Montas are injured before even throwing a regular-season pitch for the Mets. Yankees ace Gerrit Cole is also hurt and facing the prospect of possibly missing the entire season.

Having given Montas and Manaea a combined $109MM, the Mets faithful want to know how the team doctors green-lit those deals. Likewise, Yankees supporters question what Cole’s physical exams missed after the Bombers convinced him not to opt out and walk away from the $144MM left on his deal.

As a former baseball executive, I’ve fielded those same frustrated queries. Forecasting player injury risk involves far more art than science, often leaving teams and fans dissatisfied. I hear these complaints frequently since I live in the NY metro area and contribute to SNY’s weeknight show, Baseball Night in New York.

There’s rarely a satisfying answer because the assessment process is highly imperfect. Every veteran pitcher has wear and tear if you look hard enough. Acute injuries occur after the fact. Let’s examine how it typically works, its key flaws, and some ways it could be improved.

The Current (Flawed) Process
When a free agent agrees to terms, the deal is almost always contingent on a physical. The team’s medical staff examines the player, including clinical evaluations, strength and flexibility tests, and MRI imaging of joints like shoulders and elbows for pitchers.

Experts from across the organization weigh in with opinions that a head athletic trainer or performance director synthesizes into an overall risk rating for the GM. For trades, it’s a similar review of medical records, but there’s no in-person exam.

There are several issues with this approach:

• Doctors and trainers interpret MRI findings differently
• Individual expert biases color the assessments
• Lack of standardized, objective metrics
• Siloed information without enough collaboration
• Over-reliance on a single organizational voice
• Underutilization of advanced data analytics

In this high-stakes environment, a process reliant on human judgment is open to significant error.

A System Ripe for Abuse
Valid, complete information is critical for proper risk assessments. However, in this ultra-competitive industry, teams are motivated to gain edges wherever possible, sometimes unethically.

When I was with the Red Sox in 2016, we traded top pitching prospect Anderson Espinoza to the Padres for Drew Pomeranz. Our medical staff reviewed the records San Diego shared and signed off on the deal.

After Pomeranz reported, we discovered he was managing multiple health issues that were not disclosed to us. ESPN reported that the Padres instructed their athletic trainers to maintain two sets of files—one for internal use and a sanitized one for trade purposes. While MLB never divulged details, they investigated and concluded there was wrongdoing. GM A.J. Preller was suspended for 30 days (Take that, wrist!).

The incident eroded trust so much that any subsequent transactions with the Padres were thought to need additional vetting by a third party. It exemplified the system’s vulnerability to exploitation and dependence on clubs exchanging information in good faith.

From Biased Experts to Big Mistakes
Even when injury records are complete, human bias and error can still lead teams astray. As the Mets’ Acting GM before the 2021 season, I explored signing veteran starter Rich Hill. Our medical team reviewed his records and strongly recommended against the move, given his age and injury history. While I had reservations about the assessment, I ultimately decided to heed their advice and pass on Hill.

In retrospect, that was a mistake. Hill signed with the Rays for a reasonable $2.5MM and gave them nearly 100 solid innings. When we traded for him that July, I learned Rich was understandably frustrated that our medical assessment was pessimistic months earlier.

I called Rich to clarify the situation and take responsibility for the decision. While our assessor likely took a conservative approach, as the GM, I had to own the final call. This experience reinforced how these assessments can vary based on the individuals and organizational histories involved. Years prior, former Mets performance staff members took bullets, rightly or wrongly, for player injuries, influencing the current staff to take a more risk-averse approach.

Moving forward, I pushed our group to focus more on objective data and collaborate across silos to mitigate individual biases. We had to balance risks with potential rewards and understand that perfect prediction is impossible. Judgment calls wouldn’t always work out, but we needed to approach them with discipline, openness, and the bigger picture in mind.

That same month, we selected Vanderbilt pitcher Kumar Rocker 10th overall in the draft. After the pick, we did a deep dive into his medicals, which included multiple expert opinions. Despite Rocker’s talent, we ultimately decided not to offer him a contract due to the high perceived risk. A year later, the Rangers drafted Rocker third overall and signed him for $5.2MM. Two teams evaluating similar information came to opposite conclusions. Rocker is now a top-50 prospect, excelling in the minors. Our assessment was clearly wrong, and it cost us at least a valuable trade chip and potentially a frontline starter. That’s how impactful these judgments can be.

Finding a Better Way Forward
To reduce costly human bias and error, MLB and individual clubs must evolve to a more data-driven, objective methodology. Some suggested improvements:

MLB should:

• Standardize protocols for medicals, physicals, and imaging
• Mandate sharing of training and biomechanical data
• Use validated tools to assess psychological factors

Teams should:

• Leverage AI and machine learning to analyze images (e.g., MRI) and predict injury risk
• Develop personalized biomechanical and kinetic player models
• Improve collaboration between medical, performance, and analytics staff
• Have subjective evaluators predict outcomes (e.g., innings pitched) and assign confidence scores

By taking these steps and focusing on hard data while still valuing expert insights, teams can optimize the art and science of this process. It won’t be perfect but will be significantly better than current practices.

Progressive teams are already moving in this direction, and others are sure to follow as they recognize the competitive advantages it brings. Smarter, more precise health forecasting is the future of player acquisitions. Hopefully, fans will soon have more confidence in the medical evaluations that drive roster decisions.

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Dodgers & Deferrals: A Misguided Focus

By Zack Scott | January 29, 2025 at 2:00pm CDT

Zack Scott, former Mets Acting GM and four-time champion with the Red Sox, empowers sports operations and individuals to win through Four Rings Sports Solutions. He specializes in data-driven strategies and leadership development. His Sports Ops Launchpad helps aspiring sports ops pros break into the industry. Connect with him on LinkedIn here.  Zack will be contributing periodically to MLB Trade Rumors. 

The Dodgers aren’t ruining baseball with massive salary deferrals. They may be causing a perception issue for MLB, but focusing on deferrals for the next Collective Bargaining Agreement would be a misguided effort—a political gesture that won’t address the core competitive balance issues.

Deferrals serve two primary purposes: helping teams close deals and giving players a big headline to validate their market value and boost their status. They’re not a circumvention tool around the Competitive Balance Tax (CBT) rules. Spending power, not contract structure, drives baseball’s economic landscape. Teams with greater resources have always been able to outspend smaller-market teams. This dynamic is inherent in leagues without hard salary caps.

Over the past five years, the Dodgers have become a lightning rod for fan discontent by deferring over $1B to acquire many star players. Shohei Ohtani’s $680MM deferred salary is an extreme example, but their long-term contracts consistently feature deferrals.

Let’s consider a hypothetical scenario: What if deferrals were prohibited? Would the Dodgers still have offered Ohtani a $700MM contract? It’s highly unlikely. A league where deferrals are banned wouldn’t change the Dodgers’ desire to acquire Ohtani, but it would necessitate a different contract structure. Guaranteed dollar amounts would likely align more with the present value calculations we observe in current MLB contracts.

Ohtani’s contract (97% deferred) calculates to a $460MM present value using MLB’s 4.43% discount rate. This figure makes sense in historical context, as it surpassed Trout’s $426.5MM (no deferrals), which stood as the highest for nearly five years. However, it’s crucial to understand the discount rate’s role in these calculations. MLB uses a conservative rate, which limits the CBT benefits for teams.

This standardized rate doesn’t reflect team owners’ financial realities. Many owners, especially those directly connected to global investment firms, achieve significantly higher returns. Consider Guggenheim’s Mark Walter, the Dodgers’ owner, whose firm has generated approximately 10% average annual returns, or Point72’s Steve Cohen, the Mets’ owner, with around 14% average annual returns. The present value drops significantly if we apply these more realistic discount rates to Ohtani’s deferred contract.

Using Walter’s rate, the present value would be approximately $282MM. Using Cohen’s rate, it would be even lower, around $203MM. This substantial difference reveals that the perceived CBT advantages from deferrals are less significant than they initially seem. Although deferrals offer teams greater financial flexibility in managing cash flow, their present value is inflated by the conservative discount rate used for CBT calculations.

While the CBT benefits from deferrals may be overstated, they carry inherent long-term risks. Revenue declines or ownership changes could jeopardize those large future payments. However, the Dodgers’ deep pockets mitigate these risks. Guggenheim’s returns suggest they’re well-positioned to meet these obligations. Commissioner Manfred cited the early 2000s Diamondbacks as a cautionary tale. Still, Arizona’s spending outpaced revenue, and their ownership was less diversified than the current Dodgers group, making a similar outcome unlikely. LA’s bet on continued financial success is reasonable.

My experience negotiating MLB contracts in large markets has shown that various contract structures can be critical to reaching agreements. We used salary escalators, signing bonuses, player opt-outs, and, yes, those evil deferrals. When I was with the Mets, we signed Francisco Lindor to a $341MM contract, including $50MM in deferrals and a $21MM signing bonus. While the deferrals didn’t drastically alter our CBT payroll, they were instrumental in reaching a “magic number” for Lindor, pushing him $1MM over Fernando Tatis Jr. to secure the headline highest-paid shortstop.

The “magic number” concept is crucial in player negotiations. It represents the minimum financial threshold a player is willing to accept to validate their market value and status. These numbers are rarely explicitly stated, as agents are more likely to present significantly higher buy-it-now prices and counteroffers. Effective negotiation requires understanding the underlying motivations behind this elusive target. Athletes at this level are incredibly competitive, so their reasons for setting their sights on a particular “magic number” differ from the typical fan.

Perhaps they’re motivated to be the highest paid at their position, to push the market forward to benefit the union, or maybe it’s a number that just feels better (e.g., $2MM vs. $1.95MM). Sometimes, the gap between the player’s “magic number” and the team’s offer is too wide to bridge. However, in other cases, creative contract structures, including deferrals, can be the key to finding common ground. If this flexibility didn’t exist, reaching those critical “magic numbers” would become significantly more challenging. This could lead to longer, more drawn-out negotiations—a scenario that already frustrates many baseball fans.

Mookie Betts’ contract with the Dodgers offers another compelling example. He signed a $365MM deal with $115MM deferred. While the headline figure was impressive (second largest contract behind Trout!), the present value was $307MM, placing it below a few additional contracts (Bryce Harper, Giancarlo Stanton, and Gerrit Cole). This structure allowed the Dodgers to acquire a star player while satisfying Mookie and his agent’s desire to be seen as a top-two player. In Boston, we had tried to re-sign Betts, but our self-imposed $300MM limit wasn’t enough to meet this desire. A similar deferral structure to the Dodgers’ deal might have changed the outcome.

The Dodgers and other marquee franchises play an essential role in baseball. People are fascinated by greatness and love to root for or against the best, whether it’s Mahomes’ Chiefs, Jordan’s Bulls, Jeter’s Yankees, or Ken Jennings’ Jeopardy. Baseball’s “Goliaths,” as Scott Boras calls them, drive higher interest and TV ratings, ultimately benefiting all MLB teams. While fans of smaller-market teams may express frustration over the financial disparities, eliminating deferrals won’t solve their economic concerns.

The Dodgers are drawing all the attention because they added so many big names over the last five years. This is due to several factors: their superior financial resources, their ability to optimize player performance, their winning culture, and their West Coast location, which is a significant draw for Japanese players. These factors have raised their villain status, and that’s good for baseball. But along with that comes more noise, including misplaced outcries about deferrals.

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