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TOM CRANN: It's All Things Considered from Minnesota Public Radio News. I'm Tom Crann. It's been about a month since the start of spring training. And the Minnesota Twins are gradually absorbing several players from various countries who took time away to play in the World Baseball Classic.

Pitching prospect Francisco Liriano is one of those. He's expected to pitch tonight after missing two and a half weeks to compete for the Dominican Republic. On-the-field issues tend to be front and center during this time when players shape up for the season. But off-the-field issues can dominate as well.

Our regular medical analyst, Dr. John Hallberg, is a team physician for the squad, and he joins me on the line from Fort Myers at spring training. How are you, John?

JOHN HALLBERG: I'm doing very well, Tom. Thank you.

TOM CRANN: Good to talk to you down there. And you needn't give us a weather update.

JOHN HALLBERG: I won't rub it in.

TOM CRANN: OK. What are the new issues this year that you're finding there as a physician?

JOHN HALLBERG: Well, my role with the team, as it has been for the last nine seasons, is as the Employee Assistance Program Medical Director. And that's just a long way of saying that I deal with the psychosocial needs of the team.

And unfortunately, for the last few years, those issues have really, really revolved around steroids and supplements. And anyone who's picked up the latest issue of Sports Illustrated will know that there it is, front and center, Barry Bonds story. And that's the flavor of what we're going to be discussing this spring when I give my presentations to the players.

TOM CRANN: And just give us an idea of how that's changed in the years you've been involved with the Twins?

JOHN HALLBERG: I began in 1997. And at that time, Joe Garagiola was on a major campaign to get players to quit using spit tobacco. And Major League Baseball partnered with him. And so this is basically chewing tobacco. And it's certainly an unsightly problem. It's a gross habit. It's not great to model that kind of behavior for kids.

But it looks almost quaint in hindsight to think that that was our major concern at that time. And over the last few years, as things have evolved, we were dealing with things like Mark McGuire's situation where he was openly using androstenedione or andro. That became an issue.

Then I think it was three springs ago when Steve Bechler with the Baltimore Orioles died on the field from heat stroke, basically, and the role that that drug or that over-the-counter supplement might have played. And now we're really just calling it like it is. We know that the actual use of steroids has been a huge problem at the Major League level, certainly at the Minor League level. And that has become a big focus for us.

TOM CRANN: Let's talk about steroids a year on. You were at spring training last year during the testimony on Capitol Hill. That was a year ago at this time. What's changed in that year?

JOHN HALLBERG: Well, I think if we look back, if there was a single image we can remember from that time, it was probably the current and former ballplayers sitting there wearing suits and ties with attorneys sitting next to them, looking at the panel, a very somber look on their faces.

We probably remember Mark McGwire not really wanting to comment on anything, Rafael Palmeiro denying adamantly that he had ever used steroids. And then we found out last year he actually tested positive for the use of steroids, which was just an incredible embarrassment for him and for baseball, I think.

And I think that in this last year, we finally acknowledged the fact that it has been a big problem, that it looks humorous in hindsight that there was a time when Major League Baseball actually went to the Dominican Republic to a baseball factory to see if the balls were being altered in some way because it seemed that they were flying out of the fields. And the pitchers were concerned a few years ago that the balls were being juiced. Well, it wasn't the balls that were being juiced, it was the players.

So I think that there has been a big acknowledgment. And maybe the biggest thing has been that the-- and who knows where the pressure came from exactly to make this happen? But finally, Major League Baseball itself and with Commissioner Bud Selig have come to the table with the Players Association, which is very powerful, and have agreed that the Major League guys are going to get tested now because a couple of years ago, they had a threshold number of positive tests indicating that there, yes indeed, is at least some degree of a problem.

TOM CRANN: And have they made the changes that they promised at the time again in the aftermath of those hearings?

JOHN HALLBERG: Well, the thing that's happening that's very new this year-- and this will be one of the themes of my talks this year-- will be that there are significant penalties. In the past, it's been an absolute joke that if a player got caught-- and this is both the Minor League and the Major League levels-- that there is almost a five or six strikes and you're out.

And anyone who follows the Olympics will realize how absurd that is. I mean, the Olympics, you basically have one chance. And if you test positive, even for these just trace amounts of drugs that frankly, everything from Rogaine, for example, is a possible masking agent, to things contained in over-the-counter cold preparations, you're out.

I mean, there's just no arguing. You can appeal. But you're going to lose your appeal. And to think that a baseball player could have five or six strikes before actually serving significant amounts of penalty, it just seems ridiculous.

So this year, let's say it's a steroid-- that might be the easiest thing to think of-- if that's detected, then the first offense is a 50-game suspension. And for a player who's at the Minor League level, most of whom are making anywhere from about $850 to $1,000, up to $3,000 bucks for a season, a 50-game suspension without pay is pretty significant.

If they test positive again, then it's 100-game suspension. And that can carry over to a subsequent season. And a third time, its suspension from baseball for life. So I think that there's some weight with that now.

TOM CRANN: Tell us about this therapeutic use exemption that's become more prominent this year.

JOHN HALLBERG: Yeah, and this gets back to this idea that more and more players are being diagnosed with ADD. And this is pretty interesting because the most common medication that the players are wanting to be on or are on when this has been diagnosed is Adderall, which is basically amphetamines.

I mean, it's prescribed. We use it in kids. We use it in adults. But the trouble is that a lot of the players are finding, we think, physicians who are very, very-- well, how else can I say it? Sloppy with their diagnoses. They're very quick to make a diagnosis and prescribe the medication. Just basically, X player was seen by me, has this condition, is on this medication. And that's just nobody should be writing notes like that.

And so there's a lot of question about how good of a diagnosis was made. And we're going to need to get some of these players in to have true diagnoses made because it's just not going to cut it. And unfortunately, these guys can certainly get slapped with a 50-game suspension if they get caught.

TOM CRANN: But when you get a note like that right away, you're suspicious this is a player who's trying to get an excuse to use this medication for enhancement?

JOHN HALLBERG: Absolutely. And I think that this is-- it makes me think anyway of just our society in general. I mean, obviously, performance is such a key thing, whether it's classical musicians and anxiety, or kids with subpar school performance wanting to be diagnosed, or parents wanting their children to be diagnosed with ADD so that there's an answer and a drug that can be taken to fix that, and certainly sports.

And I think it's just this continuum of striving for excellence or maybe even beyond excellence. I mean, we're trying to create superstar performers in students. And the pressures are so great that I think it's not really just an issue of baseball and drugs and sport but almost in our society in general.

And I think that it's just there's so much going on with enhancement and trying to make ourselves, whether it's physically, or mentally, or athletically better. And I think this is something we really need to look in the mirror and reflect about.

TOM CRANN: You've also seen some baseball while you've been down there, right?

JOHN HALLBERG: I have. I've not seen it. Tonight will be my first Major League game. I've seen a few Minor League games. And every day, there are usually three games going on during the afternoon.

TOM CRANN: And what's the word on the Twins? How do they look this year? And how are injuries and all of that?

JOHN HALLBERG: Well, I think that a lot of this credit goes to the Twins organization. I mean, I certainly work with the team, so I'm going to be a little biased with this. But for years, I've felt that the Twins have a different organization than a lot of teams do. We have some outstanding strength and conditioning people.

Perry Castellano, for example, who works with all our Minor League players, he believes so strongly in flexibility and stretching and yoga and all kinds of things that are a little bit outside of what we would think of with baseball players.

So we've had fewer injuries this spring than I think we would maybe expect. We're counting our blessings. From what I'm hearing from the Major League guys, they're hitting better. I think that the word in the camp is that we might be a little bit more of an underdog team this year, which actually fits the Twins better than being a team of expectation. And I think that some good things might happen this year.

TOM CRANN: All right, John, we'll leave it there. Thanks as always.

JOHN HALLBERG: My pleasure, Tom. Thank you.

TOM CRANN: Dr. John Hallberg speaking to us from Fort Myers at spring training. He is our regular medical analyst here on All Things Considered. And he's a physician in family practice at the University of Minnesota.