Dvorak: The team doctor's decision must be respected

Prof Jiri Dvorak, the FIFA Chief Medical Officer
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Following recent discussions around the role of medical staff and their relation with the coach, FIFA’s Chief Medical Officer Prof. Jiří Dvořák responds to questions from and clarifies FIFA’s position on this important matter.

Whenever an incident happens on the pitch, what is the protocol in place concerning the intervention of medical staff?

If a player goes down and the referee suspects an injury then he’s entitled to call the medical team and the team doctor from the sideline to provide medical assistance. When they are called, the medical team has to run onto the pitch and attend to the player. There are even two situations in football where the team doctor can run to the pitch without being asked, which are if there is a suspicion of sudden cardiac arrest or if there’s the suspicion of a head injury, such as concussion.

Can the coach intervene at that moment?

In medical terms, when it comes to medical diagnosis, the coach has nothing to say. It is at the sole discretion of the doctor and we at FIFA will always endorse that. This is what we teach, this is how we are educating our doctors all around the world. It is our professional rule and our ethical duty to look after the players’ health. If we let coaches intervene, we can end up with a situation where a player suffers a serious health issue as a consequence of a lack of medical attention. And then the one to be held responsible will be the doctor, not the coach.

Does the same rule apply at all levels?

Yes, the same rule applies all around the world at all levels of football, be it an international FIFA competition, a confederation’s competition or a club competition at national level.

*How difficult is it for team doctors to balance the needs of their teams with their medical duties? *

The team doctor has to be concerned only about medical treatment and the health of the players, and we have to protect this. A clear example is the new protocol for concussions introduced last year by FIFA’s Medical Committee and which applies to all FIFA competitions. The objective of this new protocol is to reinforce the role of team doctors in order to ensure the correct management of potential cases of concussion in the heat of the competition. Under this new rule, whenever a suspected incident of concussion occurs, the referee has the right to stop the game for three minutes, allowing the relevant team doctor to complete an on-pitch assessment and determine if the player has suspected concussion. The referee will only allow the injured player to continue playing with the authorisation of the team doctor, who takes the final decision.

But would there be any situation where the manager could tell the medical team not to enter the field of play?

I can’t envisage such a situation. I think we have to defend our position. Everybody on the pitch – the players, the manager, the assistant manager, the representatives of the clubs – they all have to show the appropriate level of respect and accept the decisions of the doctors who are in charge. We have been educated that way, we have years, in some cases decades, of education, training and experience, so we know what needs to be done.

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