Pep and Jose: Controlling the Doctors

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In this week’s Jose Mourinho Controversy, the Portugese malcontent has laid into the Chelsea club doctor, Eva Carneiro, for her “naive” treatment of an ‘injured’ Eden Hazard. Universal condemnation has followed his decision to remove the club doctor from the Chelsea bench, but Mourinho, in typical Mourinho fashion, has refused to back down. So Eva Carneiro and physio Jon Fearn have been frozen out of the fold at Stamford Bridge and Mourinho continues to reign with his iron, albeit erratic, fist.

Eagle eyed viewers of football medicine controversies will note the similarities to an equally confusing and disastrous incident at Bayern Munich in April of this year. After a shock defeat to Porto, Bayern’s longstanding club doctor Hans-Wilhelm Müller-Wohlfahrt quit, along with other members of his medical staff, and released a statement saying “After Bayern Munich’s game in the Champions League against Porto … the medical team were made responsible for the defeat.”

Pep Guardiola, who was responsible for the criticism that led to the medical staff’s defection, was just as belligerent as Mourinho in his response. That battle, conducted in what the English media sometimes consider the footballing boonies of Germany, felt like a clash between a master tactician and a petulant medical team. After all, you wouldn’t find four first-team players quitting the side just because their manager criticised them, so why should that happen with backroom staff?

The problem is one of autonomy. The club doctor is a trained medical professional, just like your GP. They’ve sworn the Hippocratic Oath and are employed by the football club in a private capacity to offer specialised treatment to players. Carneiro, in addition to her medical degree, has a degree in sports therapy, and that makes her a valuable asset. But it also means that she doesn’t fall under the purview of the manager. In fact, she only partially falls under jurisdiction of the chairman, because although she is a salaried employee of the club (just as your GP is a salaried employee of the NHS), the renewal of her license to practice medicine is also predicated on her fulfilling her ‘duty of care’ to her patients. So unlike the players, the coaches, even the physio, the club doctor’s role is fundamentally autonomous, and that can make for a tricky dugout dynamic.

“And these two things in disease are particularly to be attended to, to do good, and not to do harm”

The History of Epidemics

Of course, we all realised that Hazard was not terribly injured. At worst he might’ve had a bit of a bruise on his leg, so we shouldn’t pretend that it was a matter of life and death for Carneiro to tend to his wounds. But, at the same time, the club doctor’s responsibility, in that moment, is only partially to her employers. In that moment, she has to think about A) What is best of the patient, B) What is best for the organisation she works for, C) What is best for her career, and C) What is best for Chelsea, the team of which she is presumably a fan*. It’s a lot to process in an instant, and it’s a lot more complicated than, say, the Assistant Manager, whose responsibility is to get the club winning games. Simple as that.

Guardiola and Mourinho, in criticising their medical teams, are infringing on the independence of an important department at the football club. It’s a difficult line to tread – and the media should avoid slipping into banal aphorisms about the medical profession – but the problem is one of control. Guardiola and Mourinho are both holistic managers. They thrive on controlling the football club from top to bottom, from tactics to the boardroom, from transfers to PR. They are the two biggest club managers in the world, and it’s no surprise that they have difficulty when confronted with the one department at the club over which they cannot, much as they may want to, exercise that same control.

It remains to be seen whether Mourinho will back down in this row. He was bullheaded again today but I suspect that at some point, probably after the game against Man City (if Chelsea win), he will offer an olive branch to Carneiro and Fearn. As far as I can see, the problem here is about authority and hierarchy, though the fact that Carneiro is one of very few women to sit on a Premiership bench, has, inevitably, raised questions about sexism and whether her gender has influenced Mourinho’s criticism. Ultimately, however, Chelsea are one of very few teams in the world who employ a woman as their club doctor, and it’s very easy for other teams to call Mourinho and Chelsea out for their treatment of Carneiro whilst comfortably continuing not to employ women in key positions at their clubs. It is, I think, better to employ a woman and criticise her performance than it is to not employ a woman at all (provided that your criticism is based on their actions which, in this instance, is the case, even if it’s a wrongheaded one).

But any manager, at any club, must realise that the club doctor does not answer to them. As at Bayern, Chelsea could easily replace Carneiro, but the situation will never change: the club doctor is responsible for keeping their patients healthy, not winning points for the football club.

*It’s been pointed out that Carneiro is technically a fan of Real Madrid. What I mean, however, is that she is presumably hoping that Chelsea win their matches. In that sense, whenever she sits on the Chelsea bench, she has some partisan considerations.

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2 thoughts on “Pep and Jose: Controlling the Doctors

  1. So, if Jose only has a Physio on the bench (.i.e. no doctor) then he can be FULLY in charge or does he have to have a Doctor on the bench?

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    • Hmm not sure whether Chelsea are obligated to have a doctor on the bench, but I think there has to be a doctor amongst their support staff. Punishing Carneiro by banishing her from the bench doesn’t solve Mourinho’s autonomy issues, but, as they say, out of sight, out of mind.

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