Coaches: The Doctors of Sport (or...Who's In Charge?)

I'm always impressed by the way doctors have created and managed the medical hierarchy. As a coach, my medical staff has always been managed according to the wishes of our doctor. Specifically, if something is wrong, you see the doctor, the doctor will diagnose it, then you see someone else for treatment. That is, the doctor is the hub, and manages everything else, relying on experts in a range of specific fields.

I'm not criticising this process, I completely agree with it. But I'm always impressed with the strength of this structure. I suspect it is harder to harder to manage, with more and more sub-disciplines of medicine developing all the time. I also suspect that because the doctors were the first on the block, so to speak, this has helped with with their point at the top of the food-chain.

Recently I was coaching a team where someone organised physical treatment support, which was a fantastic addition to the program. Unfortunately it is a very long time since I had worked with any medical staff who hadn't been gradually and fully integrated into a program, so I'd forgotten some of the pitfalls. Two such examples were where I was told that an athlete was injured and had been receiving treatment, but that it was ok because she had been run through a fitness test and had been ok'd to play. Another example was where, two minutes before the end of match warmup, I was told an athlete was going to be pulled out of warmup for treatment because he thought she was favouring one side due to injury.

Now, neither of these things are necessarily wrong, but in any highly functional sporting environment I have been involved with, these decisions are collaborative between medical staff and coach and, unless it is a serious injury, the coach makes the final decision.

I was reading this blog post on coaching and science, which included the following quote: "Coaches should be good at coaching and teaching. Everything else should be left to specialists, people that know what they are doing." As always, the coach in me's first reaction was that this approach is doomed. I say that from some experience of working within this model, but also because I fundamentally think that someone needs to be in charge. If the coach was teaching, and other specialists were doing other things, then who would be in charge? How would the situations mentioned above be avoided?

Historically, the person in charge has been the coach. Probably for the same reasons as the doctor, because theirs was the first 'profession' involved in the industry and also that they were the person who had the most contact with the athlete/patient. The biggest difference to medicine is that coaches didn't go to university for 6 years before getting a job!

Developing an athlete to become a World or Olympic medallist is no easy task. It is complex, and becoming more complex. Simply 'leaving' things to specialists is never going to work, because someone needs to be in charge. Should this be the coach? Probably. Should this be the specialist? Probably not. The key isn't the title though, its the skill set. Whoever it is needs to be able to manage the process of developing the athlete. They need to be an expert in this, and they need to be able to manage all the processes surrounding it. Whatever the title is doesn't matter, but there needs to be someone in charge.

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