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Abstract
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.Br J Sports Med 2001;35:281–284
Advertisements for club doctors are rarely published in medical journals, doctors normally being appointed on a “who you know” basis. It is also particularly disappointing that, at a time when the specialty of sports and exercise medicine is being established in this country, the majority of doctors working with professional footballers have no qualifications or little experience in the specialty. However, this is not confined to football clubs and probably also applies to rugby clubs and many other sporting associations.
One aspect not mentioned in the paper is medical litigation. It is to be hoped that doctors involved with football …
... 8 The report, which attracted considerable media (e.g. Daily Telegraph, 18/11/1999; Daily Star, 18/11/1999; Independent, 18/11/1999; Daily Mail, 19/11/1999; Guardian, 21/11/1999) and professional comment, 9,10 made ten recommendations related to the education, training and appointment of club medical personnel. Among them were that all vacancies should be publicly advertised; candidates should be formally interviewed; interview panels should include at least one independent medical practitioner; appointees should have written job descriptions; specialist sports medicine qualifications should be identified as desirable in club doctor person specifications, and clubs should assist employees to obtain them; clubs should develop a more professional medical service and move towards paying club doctors at recognised professional rates; all new physiotherapy appointees should be chartered while non-chartered 'physiotherapists' should only work under the supervision of a chartered physiotherapist; and club doctors should be fully involved in physiotherapy appointments. ...
Objectives
to compare the current methods of appointment, qualifications and occupational experience of club doctors and physiotherapists in English professional football with (i) those outlined in a study published in 1999, and (ii) Football Association (FA) medical regulations.
Design
Qualitative.
Methods
Postal questionnaire survey of (head) doctors and physiotherapists at each of the clubs in the English Premiership, Championship and Football Leagues 1 and 2. Response rates of 35.8% and 45.6% respectively were obtained.
Results
The majority of football club doctors are GPs who have sports medicine qualifications and relevant occupational experience. Time commitments vary from full time to a few hours per week. Most are appointed through personal contacts rather than job advertisements and/or interview. Almost all football clubs have a chartered physiotherapist, many of whom have a postgraduate qualification. They work full time and long hours. Most are appointed through personal contacts rather than job advertisements. They are frequently interviewed but not always by someone qualified to judge their professional expertise.
Conclusions
Football club medical provision has become more extensive and increasingly professional over the last 10-20 years, with better qualified, more career-oriented and more formally contracted staff. It is likely that clinical autonomy has subsequently increased. However recruitment procedures still need to be improved, especially in relation to advertising vacancies, interviewing candidates, and including medical personnel on interview panels. In two aspects clubs appear not to be compliant with current FA medical regulations.
This mixed methods study explored the frequency of sport/exercise-related injuries in nonelite sport, participant-reported management and perceptions of potential injury consequences. Focus group participants, who trained two to four times a week and had previously sustained musculoskeletal sports-related injuries, reported seeking medical advice secondary to advice from teammates or online research. General practitioners were viewed as gatekeepers to specialist secondary care and less able to effectively treat sport-related injuries. Participants displayed limited awareness of potential future implications of injury, and considered physical and psychological benefits of exercise more valuable than potential injury-associated risks. In the survey of physically active people, over half reported sustaining an exercise-related injury (562/1002, 56%). Previously injured respondents were less likely to consider consulting a health professional for injury-related advice than those with no injury history (45% vs 64%; P < 0.001) and more likely to continue exercising despite injury (51% vs 37%; P < 0.001). Concerns about injuries largely related to short-term issues; only 32% were concerned about possible long-term joint problems including osteoarthritis. Exercise-related injury was common in nonelite exercise participants. There was some dissatisfaction with care pathways for sports-related injuries and a lack of awareness about appropriate injury management and potential consequences of injury, particularly in the long-term.
To examine the methods of appointment, experience, and qualifications of club doctors and physiotherapists in professional football.
Semistructured tape recorded interviews with 12 club doctors, 10 club physiotherapists, and 27 current and former players. A questionnaire was also sent to 90 club doctors; 58 were returned.
In almost all clubs, methods of appointment of doctors are informal and reflect poor employment practice: posts are rarely advertised and many doctors are appointed on the basis of personal contacts and without interview. Few club doctors had prior experience or qualifications in sports medicine and very few have a written job description. The club doctor is often not consulted about the appointment of the physiotherapist; physiotherapists are usually appointed informally, often without interview, and often by the manager without involving anyone who is qualified in medicine or physiotherapy. Half of all clubs do not have a qualified (chartered) physiotherapist; such unqualified physiotherapists are in a weak position to resist threats to their clinical autonomy, particularly those arising from managers' attempts to influence clinical decisions.
Almost all aspects of the appointment of club doctors and physiotherapists need careful re-examination.
Speakers include: Kirsty Further details: Mrs Sue Roberts, BASEM Company OYce, 12 Greenside Avenue
- October Vale Of Glamorgan
- Uk Wales
- Richard Arbuthnott
- Tom Busgett
- Rhondri Crisp
- Gerry Evans
- Paul Haggerty
- Ken Jackson
- Ben Kelly
- Tony Kibler
- Paul Lewis
- Ron Massey
- Paul Maughan
- Mccrory
- Nicholas Miller
- Michael Peirce
- Stroud
October, 2001; Vale of Glamorgan,
Wales, UK.
Speakers include: Kirsty Arbuthnott, Richard Busgett, Tom Crisp, Rhondri Evans,
Gerry Haggerty, Paul Jackson, Ken Kelly, W
Ben Kibler, Tony Lewis, Paul Massey, Ron
Maughan, Paul McCrory, TK Miller, Nicholas Peirce, and Michael Stroud.
Further details: Mrs Sue Roberts, BASEM
Company OYce, 12 Greenside Avenue,
Frodsham, Cheshire WA6 7SA; Tel/Fax: +44
(0)1928 732 961; email: basemoYce@
compuserve.com
New Zealand Sports Medicine
Conference
Keynote speakers are Ken Crichton, Craig Purdham, and Louise Bourke. Further details: Conference Secretariat
November 2001; Sky City, Auckland.
Keynote speakers are Ken Crichton, Craig
Purdham, and Louise Bourke.
Further details: Conference Secretariat, PO
Box 6396 Dunedin, New Zealand; Tel: +64 3
477 7887; Fax: +64 3 477 7862; email:
smnznat@xtra.co.nz.
Report of the medical working party of the Football League
- R M Gibson