Concussion test to protect players and clubs from themselves

the Doctor's indecision at the crucial moment was a cringe worthy moment!

All good Chivas. I agreed with what you had said before and what you say in this post. The life and death line i mentioned was in relation to an earlier post of someone else with whom i disagreed. thanks for clarifying though as its a very complex, subjective and touchy subject. kpm, couldnt agree more again; as you point out 'team doctors' are not only doctors, they are also employees. and yes it does change everything.

Yes Brett our heads are all in the same place

nos sorry I was away from the computer for so long that I only just saw this. Of course doctors are can be influenced: I don't know a single profession where pressures can never affect the decisions people make and stop them being objective. The whole notion of a 'team' doctor deciding seems wrong to me. I think an independent figure should be in charge.

The Bush sorry but I wasn't able to look at the computer for a long time so I doubt you would read my reply to this now: there will be an article on the issue soon so we can continue there. I wasn't talking about this example, but the larger question of whether players with concussions should play on.

I mentioned life and death examples as clear examples where even on the extreme end there are mistakes made and poor decisions for which there is no accountability. So how much more likely when a decision doesn't typically lead to that. So firstly debunk the myth that there is accountability by law. The point I was making was remove the situation where it is possible for a doctor to make a snap decision for the sake of a game or pressure from a coach or player. If he starts wobbling pull him off. So I am guessing getting another severe knock would make no difference. Yet I know players who have been told it is dangerous to continue playing as they have had too many knocks but they do. And these are for teams which have team doctors and are high profile. The point is simply there should be structures which enable a decision to be made away from pressures to return a player to the field. If I didn't make it clear in my previous posts. I hope this does.

Brett sorry for the slow reply: I think it's a sign of moral courage to stand up for players on the issue as it's the kind of thing that many are too afraid to talk about so hats off.

Sorry, the point I was trying to make is that, from what I've heard, the PSCA may not be sensitive enough to reliably clear a player of concussion, regardless of how the PSCA is administered or what its guidelines are. This is based on information from a doctor who attended last year's international conference on concussion in sports - apparently, changes can be detected on brain scans (of some sort, not sure which!) even after players test perfectly well and are symptom-free. Anyway, there seems to be a lot of research still ongoing, and I wouldn't be surprised if there's changes in the coming years to how sports deal with these issues. On another note, do you know which PSCA the professional teams use? The one currently the ARU currently promotes is the SCAT2, which provides a score but no pass-fail criteria in the guidelines - it's all about overall presentation and how the player scores relative to their norm (otherwise a really unco player would be getting pulled off all the time :D)

Kpm, I am only reading what you have written now as I had a big day and I have to admit I do agree with the majority of what you have said. yes doctors can be influenced. Are most of them more than fine, comeptent and professional? Of course they are. for the roarers who are talking about life and deaths issues, lets be honest, this does not represent the majority of the cases we are talking about on rugby fields. I understand that MOC and maybe the bush are docs or are in similar professions. I have been working on the other side, the 'bad one', the big pharma companies, in clinical trials, adverse events and sales for 15 years and have been meeting docs on a daily basis, mostly one on one or in hospitals. And yes, although I have no doubt most doctors would do the right thing in a case of emergency or life/death situation and so on, I have also no doubt that these doctors are influencable as Kpm puts it in the situations we are talking about here, I.e. mild concussion assessment, injuries etc. We aren't in an ideal world and doctors, scientists etc are no different.

Ok, what I was trying to say is that as someone who is and has been working in the pharmaceutical industry for a long time and talking to doctors on a daily basis, I don't agree that doctors, sports or team doctors, are some kind a superior being who are incorruptible and because they have pledged allegiance to Hippocrates and so on always act in the best interest of their patient, in this case, the players. This is not true. I am absolutely certain than most of them are fine and extremely professional. On the other hand, do I think team docs can sometimes feel pressured to give the all clear to players because the coach or president want the guy to play next week? Yes I do. They are like you and me and in some cases will do what they are told.

I think we are going in circles. He can do that already, the player can't argue with him, nor the team captain. The only people who could disagree are the support staff. . I don't see the waterboy trying to override him, so that leaves the team Dr.? The Dr can either agree and take the player off, or as in this case assert his medical opinion. I don't think many refs want to argue medicine with the Dr, nor should they. Refs have enough to worry about without the potential fallout of him needlessly sidelining a player when something dramatic then went on to occur on the field. Teams have Doctors, leave it to the professionals.

Yeah, that was why I initially complimented him on his actions. I think though, that this type of incident has now brought up the question (as this is the first time it happened) whether the referee should have more power, and importantly, the player should not have a say in whether he gets tested or not. Any law normally have trials, but they are still "living" entities which gets adapted, and we are likely to see more examples where something happens out of the suspected which could see the law adapted in real match situations.

Morning Brett, I am not sure exactly what the scope or responsibility of the referee is when it comes to requesting a concussion test. So that makes it difficult to assess what he didn't do. Like I said it is a shame I can't watch a replay of the incident, it would show what his initial request was when he called for the Doctor. If he asked the doctor to do a concussion test when he first came on, he did what I believe is in his scope. What we must not ignore is that the referee is not a medical doctor, therefor the decision and diagnosis does not lie In his hands. Could he have done it better? Most likely he could, did he do what is generally accepted from a referee? I believe so. He showed concern for the players safety, he questioned the doctor twice, so in my view he did what should be seen as generally acceptable by us. Sure his wording comes of a bit gruff and blatant, but hey, we aren't all eloquent and as diplomatic as politicians.