Team Doctor AND fan? Avoiding conflicts of interest and issues affecting clinical judgement in Sports Medicine

This weekend was one of the weekends that I both look forward to and dread at the same time, in equal measure – when ‘my’ team play the team with whom I am currently working as team doctor.

I started supporting Sheffield Wednesday Football Club when I was around 5 years old, spurred on by my father who was, and still is, an ardent fan. He took me along to my first game against Peterborough United on a cold winter’s day and an exciting game led to a 3-3 draw. However, by all accounts, I was not particularly engaged with the game itself, choosing instead to run amok up and down the gangways of the main stand and only becoming particularly focussed at half time when I was given a bag of sweets to demolish.

Nevertheless, I grew into a diehard Wednesday fan myself and became a regular season ticket holder, attending games regularly with my father. Much of my childhood conversation at home and at school was on the topic of how the Owls were performing each week. I still remember well the first day that I became a member of the Young Owls Club, proudly sporting my Club badge, shaking hands with some of the players and collecting autographs. One of the players whose autograph I still have from that day was Gary Megson, an honest and hard-working midfielder. He was later to become Club Manager, having been appointed just last year to the role with the Club. I still have a close affiliation with the Club as a fan, and those conversations about the team with my father still remain as regular as they were over 30 years ago.

Although I have looked after several different teams in the past and have been involved in lots of different sporting events, the first time I was called to be involved in any sort of Professional capacity at an event at which ‘my’ team were playing was last year when Leyton Orient were due to face Sheffield Wednesday in Sheffield at Hillsborough, the ground in which I had spent so much of my time over the years watching my team.

In Football League 1 in the UK, it is standard practice for the home team doctor to care for both the home and away teams during the game itself, so there was no requirement for me to attend that day as club doctor for Leyton Orient. However, I was very keen to go along as a football fan, at least. Despite being invited to take up my usual position on the bench with Leyton Orient, my instincts told me that I would be much better off in the stands with my father and brothers watching the game as a fan. It was with a strange mix of emotions that I watched the match that day, feeling a desire for both teams to do well and certainly not feeling like a team doctor. Being up in the stand, I could enjoy the game as a spectacle rather than approaching the game as I usually do when I am on duty as team doctor.

Later on in the season, Leyton Orient played Sheffield Wednesday in London. Although I approached the game with a little trepidation at first, I felt much more professionally detached and objective on the day which was perhaps down to the familiarity of my usual working environment. I found it relatively easy to concentrate on my club doctor role and to care for both sets of players on the day.

There are a number of possible ways in which being a fan might potentially cause a conflict of interests or influence the clinical judgement of a team physician both in a conscious or  in a subconscious manner. Perhaps the most difficult situation is when a clinician is both team physician and a fan of the same team – a situation perhaps not as uncommon as one might think. The team physician may or may not start out as a fan of the team, but they may develop into a fan without being truly aware of this such that objective clinical judgement may be affected and insight might be poor. A decision might be taken, for example, to ‘patch up’ an important player in a vital game and let them continue to play rather than taking a different view.

Whilst conflicts of interest between what might be best for a player and what might be best for a team are not so uncommon and are well known to team doctors, matters of clinical judgement related to a doctor’s ‘fan status’ may not be so apparent, and there may be a lack of awareness on all sides.

Perhaps the most important requirement for a team physician in order to prevent any potential adverse effects on objective clinical judgement alongside a Professional approach is the capacity for self-reflection and insight.

Is it time for clear ethical guidance on this issue?

Should we have a section on a team doctor’s annual appraisal on probity issues related to ‘fan versus doctor’ to facilitate and encourage reflection?

CJSM would like to hear your views.

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About Chris Hughes
Associate Editor, Clinical Journal of Sport Medicine

3 Responses to Team Doctor AND fan? Avoiding conflicts of interest and issues affecting clinical judgement in Sports Medicine

  1. Dr Mike Burdon says:

    Interesting thoughts Chris and a very relevant issue in my opinion.
    The bottom line in my view is that one is there as a professional clinician. I suspect you ( like me) are able to behave like one and not a fan on the day.
    I feel uncomfortable even celebrating a goal on sideline as one could argue this is not necessary or perhaps relevant to the job. I would perceive this to be more of an issue when covering both teams which as you say often happens in the lower leagues. If at premier league club then I suspect this may be different. In the end though whatever the set up one is there to use expertise to cover any illness or injury and not let any other factors get in the way ( I once saw a physio many years ago get involved in a tussle whilst attending an injured player- not good !).

    • Chris Hughes says:

      Thanks for the comment, Mike.

      Interesting thoughts re: celebrating goals / good play etc from one team

      What do our readers think?

      Is it acceptable for a team doctor to encourage ‘their’ team (ie the team employing them to provide medical services) or to celebrate a goal scored by their team whilst they are on pitchside duty? Does the answer to that question depend upon whether or not they are responsible for pitchside care for both teams on the day?

      Should clinicians never show any emotion either way, and remain impartial and focussed?

      OR – should clinicians actively celebrate the success of their team whilst they are on duty?
      If so, what are the dangers associated with that? Where does that sit with ethics and Professionalism?

      A penny for your thoughts,

      Chris Hughes

  2. Osman Ahmed says:

    As a physiotherapist that has been involved with elite sport for many years I would argue that it is almost impossible not to celebrate with the team! The time, energy, and emotion invested in working to ensure that the players are at their physical peak means that celebrating when a goal is scored is a natural release. Im fortunate to have been considered “part of the team” in all of the squads that I have worked with, and therefore I would almost consider that sharing in these experiences would be an unwritten and unstated part of the job description.

    This all needs to be put in context however- the example cited of a physiotherapist becoming involved in a tussle with a player is clearly unacceptable in the same way that goading of the opposition bench/supporters or haranguing the referee would be! Football (where I have primarily worked) is a very intense game, with passions frequently overflowing. Keeping them in check and respecting the laws required by the professional medical associations we belong to is crucial. As is the case for all persons involved in sport respect should be shown to your opponents, including whilst celebrating.

    These dynamics are possibly different for a team Doctor which is covering both squads, as opposed to physiotherapists who are generally assigned to just their own team. In this instance I would argue that the Doctor should possibly show a greater degree of restraint. It could make for a potentially awkward situation should the Doctor have to treat a player if only a few minutes earlier he was cheering a goal scored against them.

    Id also be very interested in the thoughts of others on this….

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