More recently, the Australian Football League (AFL). announced “is considering appointing independent doctors to all AFL matches to assist club medical staff in identifying and assessing players for potential head injuries.”
The announcement followed the recommendations of a Crown investigation following the death of former AFL player Shane Tuck, who committed suicide in 2020.
An autopsy of Tuck’s brain revealed a complicated case of chronic traumatic encephalopathy (CTE), a neurodegenerative disease associated with repeated head injuries.
CTE is a type of dementia that’s more more likely to be diagnosed in people exposed to repeated head trauma, similar to athletes practicing contact sports.
The governing bodies of those sports, including quite a few football codes in Australia, have been trying for several years to reassure players, parents and the public that their games are protected to play.
Why are independent doctors needed?
One of the most significant concerns a couple of concussion (also often known as mild traumatic brain injury or mTBI) is the risk that the athlete may suffer serious neurological damage in the event that they suffer recurrent brain damage inside a brief time frame.
This is why many contact sports organizations have been established around the world and in Australia exclusion protocols for players with concussion to forestall further brain injury during the recovery period.
In Australia, mandatory exclusion periods vary between sports. AFL recently announced would adopt the Australian Institute of Sport’s (AIS) suggestion of a 21-day exclusion from matches and training for non-elite or ‘community’ athletes.
The rules are different for players playing in elite AFL and AFLW competitions, who must only be sidelined for 12 days following an injury.
The first step in the exclusion process is to find out whether the player has suffered a concussion. Currently, this decision is made by the club doctor – a licensed medical doctor employed by an AFL or AFLW team.
Concerns have been raised about the impartiality of club doctors and the possibility that their decisions, consciously or unconsciously, are influenced by their desire to see their club succeed.
The next suggestion is that if independent doctors were employed by the AFL or AFLW reasonably than the clubs, they’d be higher capable of make a diagnosis without the influence of coaching staff or other players.
With pressure comes risk
Being embedded in a high-performance sporting environment may influence people, including physicians, to assume: win-at-all-costs attitude.
If the AFL and AFLW resolve to adopt independent concussion doctors, it can not only relieve club doctors of a few of their responsibilities related to players’ brain health, but in addition remove one other key decision-making group from the process – coaches.
Some coaches are strongly against removing coaching staff and club doctors from decisions regarding concussions. In the National Rugby League (NRL), which has employed independent doctors since 2022, they act as coaches Ricky Stuart and Wayne Bennett They claim that it is a signal that the authorities don’t trust the coaching staff and club doctors.
However, the Code argues that this will not be a matter of trust, but reasonably an assurance that decisions regarding player welfare are made impartially by people with specific training on this area.
It has been argued since the focus ought to be on performance, legal and moral perspectives that give attention to the care of athletes to practice sports in all codes.
Indeed, some coaches did this most important supporters of public opinion However, there isn’t any suggestion that coaches or clubs don’t care about the health of their players.
However, the pressures of elite sport and the experience and training of many coaches, especially those that are former players, can create an environment through which player health is seen as an inexpensive sacrifice for good performance and competitive success.
Removing doctors from this environment is meant to help them make more impartial decisions regarding concussions.
Are independent physicians the right move?
The introduction of independent doctors is a step change reasonably than a fundamental change for the AFL.
The AFL’s approach to treating brain injuries is just that – it “cares” for brain injuries because the league, along with those managing other high-contact games, know that any significant reduction in the incidence of brain injuries would require fundamental changes in the way sports are played.
Ultimately, introducing independent doctors is an exercise in tinkering that may have no measurable impact on reducing the variety of brain injuries suffered by elite players.
Time will tell how the AFL could attempt to introduce an identical concussion observer system for the lots of of 1000’s of recreational footballers across Australia who play the same games as their skilled counterparts but are watched by far fewer eyes.
It can be necessary to notice that emerging evidence suggests that the risk of developing a long-term neurodegenerative disease similar to CTE is most strongly related with repeated micro-shocks that can not be diagnosed by a physician, either independent or otherwise.
If the AFL and AFLW adopt independent doctors, it can be a positive step towards continuing to prioritize player welfare, but it can not solve the problem of concussion.