From Baghdad to the Buccaneers: Lessons from the field

With a career spanning military medicine, academic leadership and professional sports, Fred Brennan, DO, has built his practice on a foundation rooted in the core principles of osteopathic medicine. A board-certified family medicine physician with fellowship training in sports medicine, Dr. Brennan serves as a team physician for the Tampa Bay Buccaneers and the Toronto Blue Jays, caring for elite athletes across two of the nation’s most demanding professional leagues.

He also holds academic appointments at the University of South Florida (USF), where he serves as an assistant professor in the Morsani College of Medicine Department of Family Medicine, in addition to his roles as associate director for both the sports medicine fellowship and the family medicine residency programs for the BayCare-USF affiliate partnership.

Following is an edited Q&A.

What initially drew you to osteopathic medicine, and how has the DO philosophy shaped your approach to treating athletes and families throughout your career?

When I was younger, I met many DOs along the way. I was always impressed by how down-to-earth and level-headed they were, as well as how holistic their approach to patient care was. The osteopathic philosophy of care really resonated with me.

As a DO, I look at the whole picture: exercise, nutrition, spiritual well-being and sleep hygiene. If you do all the right things and avoid abusing your body, your body has the ability to heal itself in many cases. Patients really appreciate that philosophy.

I was intrigued by the idea that we could treat the patient as a whole, by paying attention to not only medicines and procedures, but also lifestyle, mindset and other influences on health. Even early on, it made sense to me that it’s important to take care of your body the right way and leverage the body’s natural ability to recover.  

I wanted a career field in which I could incorporate that philosophy every day, rather than just treating symptoms. This was a major reason I chose osteopathic medicine.

Over the years, I have seen how that outlook helps me connect with patients, especially athletes. Instead of focusing only on getting them back on the field, I will talk about recovery, nutrition, rest, balance and stress, so they can return not only faster, but also stronger and healthier than before. For me, osteopathic medicine means always seeing the bigger picture. We need to treat not only the broken bone or injured hamstring, but also the person behind it.

You serve as a team physician for both the Tampa Bay Buccaneers and the Toronto Blue Jays. With the Super Bowl approaching, how does working on the sidelines of a National Football League (NFL) team compare to supporting athletes through a long Major League Baseball (MLB) season?

The NFL and MLB seasons are very different. On NFL game days, the atmosphere is intense. Players are hyped up, preparing like gladiators getting ready for battle. You can feel the excitement and energy as soon as you enter the locker room. The risk of injury is high; the treatment is more urgent and the stakes for every game are huge. Standing on the sidelines, I need to be ready for anything at a moment’s notice.

In contrast, an MLB season is a marathon. Baseball players are much more laid-back, as they have to maintain themselves for many more games in the season. My main work with MLB is during Spring Training and with minor league teams, covering physicals, general healthcare and injuries that are usually less traumatic than what we see in football. Most of the Toronto Blue Jays’ medical care happens in Canada during the season, while we cover the U.S. side.

The NFL requires more sideline presence and rapid response, whereas in baseball, the job is about consistency and supporting athletes over the grind of many months. Both are rewarding, but they require different approaches and mindsets.

As someone trained in both family medicine and sports medicine, what inspired you to pursue this dual path, and how do these specialties complement each other in your daily practice?

Three-quarters through med school, I thought I would be an orthopedic surgeon because of my athletic background and desire to care for athletes. My assumption was you had to be an orthopedic surgeon to work in sports medicine. After some orthopedic rotations, I started to realize surgery wasn’t the right fit for me.

A family medicine rotation changed my perspective. The residents had a wide knowledge base and cared for everyone: children and adults, in both inpatient and outpatient settings. John Blocksom, DO, an orthopedic surgeon and sports medicine interest group advisor, explained that primary care doctors can do most of the sports medicine care. This path allowed me to still work with athletes through non-operative orthopedics and helping manage rashes, concussions and return-to-play decisions without being locked in an operating room.

This mix fits me better and allows me to have a broader impact. Most primary care sports medicine physicians were and are family doctors. That combination lets me manage acute athletic injuries and provide long-term care, preventive medicine and whole-person wellness. It’s rewarding to support athletes’ recoveries and also care for the health of their families, coaches and communities.

You’ve completed demanding endurance events like the Boston Marathon and the IRONMAN Triathlon. How do your own athletic experiences shape the way you counsel and care for athletes at every level?

Having a sports background, including playing college football at the University of New Hampshire, and participating in endurance events like the IRONMAN and other marathons makes me more relatable to my athletic patients. I know what it means to deal with injuries and have the drive to get back to the sport you love. My athletic experience means I can empathize and connect on a level beyond just medical advice.

I stay in shape and “walk the walk,” which helps build trust with athletes. When they learn I have completed big events and understand the commitment and challenges they go through, they’re more likely to trust my recommendations for treatment, recovery and prevention. I use my experiences to show athletes that I’m invested in not just their performance, but also their overall health and future.

When counseling an athlete about returning to play, managing a stress fracture or recovering from a concussion, I draw on my own journey, sharing what worked for me and what others have found effective. That shared experience goes a long way in building the kind of relationship that actually changes outcomes for the better.

You’ve had a distinguished military career, including a 20+-year service record. You retired as a Lieutenant Colonel and were awarded a Bronze Star Medal for your service as an emergency physician in Baghdad during Operation Iraqi Freedom. How did your experiences in the military influence you?

Going to an austere environment like Baghdad gave me a deep appreciation for being back in the United States with all the resources we have here. Living in the desert for six months, sleeping on a cot and living through sandstorms built my resilience. You appreciate things like real walls, clean air and running water in a way you never would have otherwise.

My time in Baghdad taught me the importance of a positive attitude. You can either complain or decide to make it work for the time you are there. That choice affects not only you, but everyone around you. The bonds you form with the people you work with are strong because you’re all in the same environment, facing the same challenges. Sharing those experiences teaches you to communicate openly, empathize with what your team is going through and recognize the workload everybody is carrying.

My leadership style is based on demonstrating understanding, communicating clearly and being willing to do the hard work myself. If a leader needs something done, they should be willing to do it too. For example, while at Fort Bragg, I remember the family medicine physicians were asked to help with emergency room overflow without extra support. A senior leader came to work one of those shifts and decided he wouldn’t schedule himself again, due to how hectic and busy it was, but he didn’t offer any solution for that exact problem. That was a defining moment for me, as I realized I would never step back and expect others to do work that I wouldn’t do myself.

It is about showing your team you’re willing to get in the trenches. That mindset helps with patients too; understanding what it is like to be at the receiving end of care, relating to their fears and being honest about challenges we’re all facing. That military foundation of resilience, commitment, communication and empathy guides how I lead and how I provide care every day.

In addition to your clinical work, you serve in key academic with BayCare-USF affiliated training programs. What do you value most about mentoring residents and fellows? What do you hope to instill in the next generation of osteopathic physicians?

We are all physicians regardless of our degrees. In mentoring residents and fellows, I see real value in the collaboration between DOs and MDs. Many allopathic physicians are interested in holistic, lifestyle-focused care now, and many seek out manipulative medicine techniques to help patients. That shared curiosity and respect enriches both groups.

I tell residents that medicine is not a nine-to-five job; the responsibility for patient care comes first. It’s not just about learning the science: it’s also about commitment and balance. Watching residents and fellows go from being tentative and nervous to confident and skilled is incredibly rewarding. They begin not knowing everything, but as they grow, their confidence emerges and by graduation, they appreciate their training and know how to keep learning.

I remind them that it’s normal to feel overwhelmed at first. Like basic military training, with time, they’ll build resilience and experience. I encourage everyone to reach out to their mentors for guidance, support and advice even after leaving the program. That ongoing connection is part of what makes academic medicine so special.

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From courtside to bedside: WNBA team physician forges her own path in sports medicine

How a passionate DO became a bodybuilding champion

How physical activity trains our brains for medicine—and how to fit it into your schedule when you’re in training