The medical welfare of elite athletes: the unintended consequences of organisational change

This chapter documents the intended and unintended outcomes of three recent organisational changes in sports medicine. It argues that these combined developments have provided opportunities for clinicians to work full-time, be involved in supportive networks and assisted those wishing to enter or progress in sports medicine through a more structured career path. At the same time, however, the commitment to ‘professionalising’ sports medicine has led to inter- and intra-professional tensions between practitioner groups. In particular, in polarising medical support around the Home Countries Institutes of Sport (HCIS) the labour of some medical providers is being increasingly marginalised, the support offered to athletes in different sports remains inequitable and, due to the closer link between sports performance and funding, there is evidence to suggest that medical support is likely to be withdrawn from athletes at the point when it is most needed. Such changes potentially have significant implications for athlete welfare.