Coach ‘Doc”

Wednesday, January 20, 2010

The coaching carousel has begun in football with teams trying to improve their situation by taking a top down approach. The hope becomes that a new philosophy with new coaching techniques and game plans will translate to success on the field. It sounds much the same as patients who make the same decision to find a new physician to lead them on the road to health and wellness. There are certain logistic differences or similarities depending upon your point of view.

A head coach needs to meld 50 players into one unit and avoid distractions to be able to beat the opposition team on the field. Preparation for the other team’s tendencies, strengths and weaknesses allow the coach and his staff to develop a game plan to meet those eventualities. It all looks good on paper until the whistle blows and the result of the game depends upon the performance of individual players. The team is only as strong as its weakest link.

The physician-patient relationship may be very similar. The patient is made up of a group of organ systems all interconnected that lead to whole body performance. Each is important in its own way and the weakness of one system may cause the whole body to fail. The opposition may come from the outside like infection or injury or it may be due to enemies within, like high blood pressure and diabetes. The physician has two jobs. The first is to work with the patient to maximize the body’s potential and the second is to make adjustment when adversity, like injury or illness, strike.

The difference has to do with oversight and results. Coaches hover over the player almost continuously during practice and the game. Keeping the each member of the team fit and making certain that the game plan is being followed consumes the coaching staff during the season. Dissecting what right and what went wrong and adjusting the game plan keeps them busy the rest of the year. Physicians see the patient briefly and give advice. It’s up to the patient to follow it…or not. The results can’t be judged by the score of a game on a Sunday afternoon but instead may take a lifetime to realize.

Some medical issues are cut and dried. A patient comes in with a laceration, the doctor sutures it, and all is well within a few days. Pneumonia is diagnosed, antibiotics are prescribed and the infection resolves. Most often, results are tougher to measure in medicine. When it comes to quality and quantity of life, the time and effort in maintaining the body and its organs pays dividends years later.
Hypertension or high blood pressure is called the silent killer since it shows no symptoms until perhaps it’s too late. As a risk factor for heart attack, stroke and other blood vessel diseases, the game is won 40 years down the road when the patient can play with his grandkids without difficulty. In diabetes, good control as a teenager and young adult may prevent blindness and kidney failure decades later. While screening tests may be helpful statistics to gauge how the game is going, the final score won’t be known for a long time.

Comparing the two worlds, a player can be quickly fired if performance lags and the coach’s expectations aren’t met. In medicine, the patient reigns supreme and the doctor usually tries to work with even the most non-compliant patient to work together on the same game plan. Coaches usually answer to team owners and can be fired at whim. Physicians answer to the patient and can be fired or replaced on a whim as well. It’s only fair, since the patient is the owner of the team and needs to find the right person with which to work; but it’s also a little unsettling since the patient can also decide not to listen to the physician’s advice and still want that same person to remain on the team.

The final result is the hope for success, though the time frames are a little different. A football coach micro-manages players with the hope of a positive result every week. A physician macro-manages a patient with hopes of getting one win a lifetime.

Leave a Reply

This site uses Akismet to reduce spam. Learn how your comment data is processed.