Never too much insurance

When Randy Johnson shoved a photographer on a Manhattan street last month, he not only landed on the front pages of New York's tabloids. The Big Unit created a momentary, light-hearted riff between the Yankees and the Diamondbacks, both of whom were partially responsible for the left-hander's behavior.

Even though Johnson was only 24 hours away from his introductory news conference in the Bronx, Bombers GM Brian Cashman called Joe Garagiola Jr., his Arizona counterpart, to remind him, "hey, (Johnson) is still yours."

Technically, that was true. The left-hander's altercation occurred as he was walking to his medical exam, the final protocol before the trade between the two teams could be completed. Until the moment Johnson passed, he was still a Diamondback. And had Yankee doctors proclaimed him unfit, the deal would have been nullified altogether.

Although such setbacks are rare, the medical exam is by no means a rubber-stamp procedure. In 1997, a Yankees' deal for Greg Vaughn evaporated when the slugger's shoulder was discovered to be too badly damaged for a passing grade. And a trade that would have sent Omar Vizquel to the Mariners after the 2003 season was also quashed when a bad knee forced him back to the Indians.

Medical exams have been in the news throughout this offseason, too. In December, there were rumors that Jaret Wright's three-year deal with the Yankees was in jeopardy because X-rays revealed extensive damage to his right shoulder. And before signing Pedro Martinez to a four-year deal, the Mets were said to be in a tug-of-war with the free agent, who didn't want to undergo any MRI whatsoever.

Martinez presumably wanted to avoid investigation of a two-year-old torn labrum, which would have explained his diminished velocity since 2003.

It turns out there was no such dispute, according to Met officials. "Pedro had an MRI just like everyone else," said assistant GM Jim Duquette. And even though Wright's signing was indeed delayed by three weeks, he never actually failed his physical.

The Yankees simply took their time deciding they could live with the mileage in his arm.

But that judgment underscores the point that virtually any veteran player, particularly a pitcher, can flunk a physical. Today's exams are so thorough, "you can find a million little things that are wrong," said one GM.

Indeed, a player is subjected to a battery of tests in the course of a six- to eight-hour stay at a hospital, including, X-rays, MRIs, EKGs, stress tests and blood tests. What doctors cannot test for, however, is AIDS. According to federal law, such screening cannot be performed without a patient's consent.

Otherwise, the player is checked, probed and prodded by a battery of internists, radiologists and orthopedists. In Johnson's case, the Yankees paid particular attention to his left knee, which has no cartilage and required periodic injections of a special gel last year.

To no one's surprise, the Big Unit passed his physical without sounding any alarms. In fact, Yankees physician Stuart Hershon told Johnson he had the ligament and joint-strength of a 25-year-old.

A day later, Johnson took the Yankees off the hook altogether, publicly apologizing for his aggressive behavior on the street -- which only cemented Cashman's point that, "these are very, very expensive investments."

The obvious question, though, is why teams aren't this thorough during the season. For instance, if the Mets had bothered to check out Victor Zambrano's elbow before acquiring him from the Devil Rays last July they might have known he needed surgery. Scott Kazmir would have never been dealt away and it's possible manager Art Howe and then-GM Duquette would have kept their jobs.

But the Mets accepted the Devil Rays' assurances that Zambrano was healthy, and paid dearly. Not surprisingly, Duquette is now in favor of chucking the honor system for more stringent medical controls.

"We have a system that says 'buyer beware' and that makes no sense," Duquette said. "The industry is ripe for change in that area and there's no reason why it shouldn't happen."

Cashman has been a leading proponent of such reform, demanding that medical exams be conducted before the completion of any trade, in-season or mid-winter. The Yankees GM said, "when you're talking about a multimillion dollar player, the more information, the better."

Yet, GMs have routinely vetoed the idea, citing logistical problems. One executive said, "how do you tell a guy, 'go take a physical' without letting him know he's being traded? If he fails or the deal breaks down for any reason, you'd be stuck with a guy who knows you were trying to get rid of him."

A's GM Billy Beane also defended the honor system, pointing out, "no one is really looking to (trade) a hurt player, because they know if it happens, you'll have trouble dealing with the 29 other teams ever again. If you pull that trick once, it'll be the last time you do it."

Besides, Beane said, GM can rely on their own eyes for in-season trades. "Unless a guy is on the DL, you have the benefit of seeing a player on the field the day before," he said. "So you know what you're getting."

Still, there's no substitute for a clean MRI -- although, as any doctor will tell you, there's no such reality in pro sports. That's where choosing a doctor becomes critical.

One of the ways teams are creating revenue is to sell their affiliation to local hospitals. It's a prestigious gig for a doctor, calling himself the official medical consultant for a major league team. But the highest bidder isn't always the most experienced in sports medicine, and that can be the recipe for disaster.

As one GM put it, "if you have an inexperienced radiologist looking at an MRI, especially if he's not used to dealing with professional athletes, he's going to give you a different diagnosis than someone who's being doing it for a long time.

"Those decisions can cost you millions."

Bob Klapisch is a sports columnist for The Record (N.J.) and a regular contributor to ESPN.com.