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• Re: The Football Club Doctor System
  I Waddington
  Published on: 20 April 2001
• The Football Club Doctor System
  Stephen H Boyce
  Published on: 30 March 2001
• Appointment and qualifications of club doctors and physiotherapists
  Ian Horsley
  Published on: 12 March 2001

• Published on: 20 April 2001

  Re: The Football Club Doctor System

  • I Waddington
  • Other Contributors:
    • M Roderick

  We welcome Dr Boyce's letter as a useful contribution to the debate which our article has generated. Dr Boyce is quite correct to raise the issue of medical litigation. As the American College of Sports Medicine pointed out as long ago as 1991, what it called "the litigation epidemic" had at that time already "begun to engulf sports medicine" in the areas of negligence and malpractice, informed consent, counselling, re-en...

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  We welcome Dr Boyce's letter as a useful contribution to the debate which our article has generated. Dr Boyce is quite correct to raise the issue of medical litigation. As the American College of Sports Medicine pointed out as long ago as 1991, what it called "the litigation epidemic" had at that time already "begun to engulf sports medicine" in the areas of negligence and malpractice, informed consent, counselling, re-entry to play decisions and other matters [1]. It is probable that we shall in future increasingly see such cases in the UK and the club doctor without an appropriate specialist qualification might be held to be more at risk in such cases.

  Dr Boyce is also correct to draw attention to the fact that, for the past ten years, the "crowd doctor" at professional football matches has been required to hold a recognised specialist qualification in Immedicate Medical Care. The fact that club doctors are not required to hold a comparable and appropriate specialist qualification is an anomaly which needs to be addressed as a matter of urgency by sports medicine authorities, by clubs and by the Football Association. It goes without saying that he is also correct to point to the need for football clubs to adopt more realistic policies towards safeguarding their major assets, namely the health - and therefore also the playing ability - of their players.

  Finally, we fully accept that, as Dr Boyce suggests, the situation which we documented in relation to professional football may not be unique to that sport. We agree that there is a need to investigate all aspects of the provision of medical and physiotherapy care in other sports. In this regard, your readers might be interested to know that two of our colleagues at Leicester, Dr Ken Sheard and Dominic Malcolm, are now carrying out a similar study to our own, but in Rugby union.

  1. Cantu, R C and Lyle, J M (eds). ACSM'S Guidelines for the Team Physician, Lea and Febiger, Philadelphia and London,1990.

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  Conflict of Interest:
  None declared.

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• Published on: 30 March 2001

  The Football Club Doctor System

  • Stephen H Boyce, Accident & Emergency Department

  Dear Editor,

  I read with interest the paper by Waddington et al,[1] highlighting the inadequacies of the football club doctor system in Britain. This paper confirms the situation that many people already knew to exist. Advertisements for club doctors are rarely published in medical journals and are normally appointed on a “who you know” basis. It is also particularly disappointing, that in a time when the specialty of...

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  Dear Editor,

  I read with interest the paper by Waddington et al,[1] highlighting the inadequacies of the football club doctor system in Britain. This paper confirms the situation that many people already knew to exist. Advertisements for club doctors are rarely published in medical journals and are normally appointed on a “who you know” basis. It is also particularly disappointing, that in a time when the specialty of Sports and Exercise Medicine is being established in this country, the majority of doctors working in contact with professional footballers have no qualifications or little experience in the specialty. However, this situation is not confined only to football clubs. I suspect that this may also be the case for rugby clubs and many sporting associations.

  One aspect not mentioned in the paper is the subject of medical litigation. Although doctors involved in club football will hopefully have arranged medical defence cover, if a situation arises where a player's sporting career was threatened by medical mismanagement, the doctor involved, with no professionally recognised sports medicine qualification, could possibly be found guilty of medical negligence. With the amount of money involved in professional football this could lead to dire future consequences for the medical career of the practitioner involved.

  After Hillsborough[2] following a report commissioned by the Football League, the concept of the “crowd doctor” was introduced whereby any doctor involved in the medical care of the crowd at a football stadium would require to possess at least the Diploma in Immediate Medical Care.[3] Prior to this the situation was similar to that of the present club doctor system where few doctors held any recognisable qualifications or training in medical emergencies and resuscitation.

  A similar recommendation by sports medicine authorities is required to enhance the quality of service provided to football clubs and increase the stature of the specialty. However, it is not a one sided situation. Football clubs must realise the importance of a medical team in looking after their prime assets, the players. Advertising jobs in medical journals, insisting upon experience and qualifications, adequate remuneration and the provision of job descriptions and contracts all require to be implemented. By working together to improve the current situation a service can be provided that both professional football players and the medical profession will have confidence in.

  References
  (1) Waddington I, Roderick M, Naik R. Methods of appointing and qualifications of club doctors and physiotherapists in English professional football: some problems and issues. Br J Sports Med 2001;35:48-53.

  (2) BBC Report on Hillsborough Disaster accessed 30 March 2001 (editor's addition)

  (3) Gibson RM. Report of the Medical Working Party of the Football League. London: HMSO, 1990.

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  Conflict of Interest:
  None declared.

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• Published on: 12 March 2001

  Appointment and qualifications of club doctors and physiotherapists

  • Ian Horsley, Lecturer In Sports Rehabilitation

  Dear Editor

  I read with great interest the article by Waddington, Roderick and Naik regarding the appointment and qualifications of club doctors and physiotherapists in English professional football.

  Further to the messages put over in the text I feel that from a physiotherapy side, just being chartered is not enough. In my experience many professional clubs are employing chartered physiotherapists, s...

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  Dear Editor

  I read with great interest the article by Waddington, Roderick and Naik regarding the appointment and qualifications of club doctors and physiotherapists in English professional football.

  Further to the messages put over in the text I feel that from a physiotherapy side, just being chartered is not enough. In my experience many professional clubs are employing chartered physiotherapists, straight out of University to look after their academies and so comply with the first regulations of employing Chartered physiotherapists.

  These physiotherapists, have little (if no) experience of managing the injuries of professional sport, and are been given the responsibility of looking after the medical needs of junior footballers. There is a move afoot within the Association of Chartered Physiotherapists in Sports Medicine to ally with the National Athletic Trainers Association in America with the possibility of producing Sports Rehabilitation and athletic trainers within this country as recognised therapists to work within sports.

  I would urge all involved in the employment of physiotherapists within sport to look for suitable candidates who have a good understanding of the management of sports-related injury.

  This will mean that the pay scales within professional football, on the medical side, will need adjusting accordingly.

  At the time when clubs are worrying about the abolition of transfer fees - stating that fees are linked to the "skill level" of the player. I feel the same system of financial compensation be applied within the medical set-up, thus raising the standard of medical back up within soccer.

  Ian Horsley MCSP SRP
  Lecturer In Sports Rehabilitation
  University of Salford, Manchester, UK

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  Conflict of Interest:
  None declared.

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