Roch confirms no MRI for Gonzalez prior to signing.

[ledzepp8]

If the doctors said that an MRI is useless in this case, I will go with the doctors there.

But what about the other side to it...What if they said you should do one and AM ignored it?

Do you really feel that's a possibility?

[square634]

If the doctors said that an MRI is useless in this case, I will go with the doctors there.

But what about the other side to it...What if they said you should do one and AM ignored it?

Well I would also go with the doctors. I can't imagine that happening though.

[Sports Guy]

Do you really feel that's a possibility?

Well, Tony did report that AM rushed the signing of Gonzo because he didn't want him to sign elsewhere.

[Sports Guy]

I consider that scenario -- avoiding a free agent for what turns out to be a bad reason -- a bad thing if it happens too often. We'll have to agree to disagree.

I think you would be surprised how unlikely it is for the MRI to accurately diagnose whether a pitcher will be able to perform over the life of his contract in the absence of a red flag on the physical exam. If the MRI shows something major, then the physical exam was invariably going to indicate that the pitcher needed the MRI.

Let me turn it around for a second on a similar hypothetical. Let's imagine (and it probably isn't too far-fetched) that we passed over a draft prospect on the basis of an abysmal Ritterpusch psychological test, and then that prospect turned out to be a bust (this is analagous to the MRI screen correctly flagging a current or future injury in the free agent pitcher). Well, we later found out that the psychological test was likely meaningless; it may have even hurt our draft performance over the years. Would you be campaigning for us to be using the Ritterspusch test on all draft prospects again? It gives more information than not doing a test, and it passes the SG stamp of approval -- the chance exists, however unlikely, that it could "correctly identify" a bust-in-the-making. The test gives you more information, and Joe Jordan and the rest of the organization could decide for themselves how much weight to give that information. Is it useless information or potentially misleading information? Who cares, because all information is good!

Do I have that right?

Also, there's a point I have forgotten to mention. Earlier in the thread you asked whether the O's doctors would be able to tell if the MRI were normal or abnormal for a pitcher. Well don't you think the O's doctors would have told MacPhail if they thought an MRI would be helpful/relevant after Gonzalez's physical? If the doctors said the MRI would not be helpful/relevant, should MacPhail have overruled them and told them to read an MRI anyway?

Who said it was going to happen too often?

We are talking about Gonzalez...no one else.

You are only looking at this from one way IMO...That the MRI will tell us what all MRIs would say about pitchers...That nothing else, out of the ordinary, will show up on the MRI. You are acting as if you are expert in exactly what was wrong with Gonzo and what would have shown up on his MRI...You, much like everyone else, have no idea what it would say and because of that and because of his age and history of arm trouble, you gather as much info as possible and trust that the doctors evaluating him know what they are doing and understand the difference between something normal and something abnormal.

[square634]

Who said it was going to happen too often?

We are talking about Gonzalez...no one else.

You are only looking at this from one way IMO...That the MRI will tell us what all MRIs would say about pitchers...That nothing else, out of the ordinary, will show up on the MRI. You are acting as if you are expert in exactly what was wrong with Gonzo and what would have shown up on his MRI...You, much like everyone else, have no idea what it would say and because of that and because of his age and history of arm trouble, you gather as much info as possible and trust that the doctors evaluating him know what they are doing and understand the difference between something normal and something abnormal.

Again, I do not doubt that MRIs would sometimes show things that seem out of the ordinary or really are out of the ordinary, even for a pitcher. But in the long run, you have to know how often those things are false positives, and how often they reflect an actual abnormality which, for one reason or another, won't affect a pitcher.

I think the one area in which we definitely agree is that you should trust the doctors, who are sports medicine specialists, to know not only how to evaluate a pitcher's MRI, but also when taking the MRI will be helpful. I find it highly dubious that MacPhail would be meddling with the medical staff.

The "too often" line referred to your idea that we should give MRI's to ALL 30+ free agent pitchers who we intend to sign. If your point is that the MRI could not have been a negative in this particular case because signing Gonzalez, injury or not, was a bad idea in the first place, then I believe you are probably correct in a very twisted way. But clearly, at the time, MacPhail/the O's thought that signing Gonzalez was a smart move in a vacuum. So the real target of your criticism is that we targeted Gonzalez in the first place, and I agree with you about that. But it's logically dishonest to then criticize them again for not using what is probably a faulty source of information. By your logic, there could have been no negative to giving Gonzalez a tarot card reading in the hope that we would find something "foreboding." The real mistake here in all likelihood was deciding to try and sign him, not avoiding the MRI.

[Sports Guy]

Again, I do not doubt that MRIs would sometimes show things that seem out of the ordinary or really are out of the ordinary, even for a pitcher. But in the long run, you have to know how often those things are false positives, and how often they reflect an actual abnormality which, for one reason or another, won't affect a pitcher.

And that's why you have doctors to interpret what you find. Its not just some blind guess qork.

The "too often" line referred to your idea that we should give MRI's to ALL 30+ free agent pitchers who we intend to sign.

Maybe not all but most...if I am giving out a huge contract to a pitcher, I want every exam possible done. If I am giving out a big contract to an aging, injury prone pitcher, I want something done. .

But it's logically dishonest to then criticize them again for not using what is probably a faulty source of information

Calling it a likely faulty source is what is illogical...YOU DON'T KNOW WHAT THE MRI WILL FIND! I don't care how much research you have done on prostate cancer...You are not an expert in what is inside an aging pitchers arm who has had history of arm issues. You have already said, its not 100%...That you don't know what its going to say...You have also said that you would trust the doctors to know what the MRI is saying.

So, if you trust the doctors and you don't know what the MRI will find before doing it, then that means you give him the MRI...You either find something that isn't good or you find something that is normal and the doctors can then determine if it is a big deal or not...You either trust in their ability to do that or not.

If it came out that we gave him an MRI, everything showed up fine and he pitched well for us, I hardly doubt that you would be coming on here and bashing them for giving him an MRI.

[square634]

And that's why you have doctors to interpret what you find. Its not just some blind guess qork.

Maybe not all but most...if I am giving out a huge contract to a pitcher, I want every exam possible done. If I am giving out a big contract to an aging, injury prone pitcher, I want something done. . Calling it a likely faulty source is what is illogical...YOU DON'T KNOW WHAT THE MRI WILL FIND! I don't care how much research you have done on prostate cancer...You are not an expert in what is inside an aging pitchers arm who has had history of arm issues. You have already said, its not 100%...That you don't know what its going to say...You have also said that you would trust the doctors to know what the MRI is saying.

So, if you trust the doctors and you don't know what the MRI will find before doing it, then that means you give him the MRI...You either find something that isn't good or you find something that is normal and the doctors can then determine if it is a big deal or not...You either trust in their ability to do that or not.

If it came out that we gave him an MRI, everything showed up fine and he pitched well for us, I hardly doubt that you would be coming on here and bashing them for giving him an MRI.

I think you are misunderstanding the definition of a false positive. I trust the doctors to interpret the MRI to the best of their ability; what I don't necessarily trust is the MRI to provide an accurate picture of what is going on. When I say false positive, I mean that a good doctor would say that the scan is abnormal, but as it turns out the person is fine. That could happen due to an artifact on an image or human error. Also, the MRI could find something in the shoulder that looks like a problem but really isn't (that isn't necessarily a false positive because the physical damage could be real). So in other words, yes, I trust the doctors to in a sense know literally what the MRI is saying, but without context, I don't trust what the MRI is saying. It's like El Gordo's situation from earlier in the thread when, without context, the image was suggestive of bone cancer. All medical tests and digital imaging exams will have false positive.

You say you want every exam possible done. But what you must mean is that you want every useful, cost-effective exam possible done. For example, a test that costs more than $12 million wouldn't be worth it by definition. A psychic evaluation would be worthless (unless you believe in that sort of thing) no matter the cost. I am not an expert on orthopedics, but I'd guess I am marginally closer to an expert on this issue than you are. People are reticent to accept that a medical exam can, in some contexts, be more harmful than helpful. Is an MRI for a free agent pitcher who passed his physical one of those examples? We don't know for sure, but I think it tells you something that the doctors didn't order it.

If it came out that we did an MRI, then I wouldn't have a problem with it because the doctors obviously would have thought it was a good idea considering the cost and probabilities of a false positive.

[Bradysburns]

I think the relevant part is worth quoting:

I'd like to know if an MRI "is bypassed 'most of the time'" by other teams. Seems odd to me, but I'm not a doctor. I'm with Roch -- you invest $12 mm, you spend $1000 or whatever it costs to do an MRI, even if the results may not definitively prove an injury.

Agreed. Especially if the guy has an injury history. I mean, we have nixed pitcher signings in the past because the physical didn't come up clean. Remember Sele? I think this situation definitely calls for further examination for anyone who is trying to evaluate this front office.

[ledzepp8]

Well, Tony did report that AM rushed the signing of Gonzo because he didn't want him to sign elsewhere.

But what does this mean? Rushed what? Does it just mean that he signed him faster than he would normally sign someone (something that people routinely criticize him for on this board)?

At this point it seems that you're complaining that there was no MRI given, even though the doctors that you're saying to trust most likely didn't advise he should be given one. You're basically saying that a minuscule amount of info is better than no information at all, which I guess is fine. But you can't very well bash them for not giving him an MRI that doctors didn't deem necessary and would have most likely provided useless information anyhow.

If you get a physical, the doctor says that everything checks out, and your arm doesn't actually hurt...should he still give you an X-Ray just to make sure it's not broken?