Scarlets coach unhappy with Pro14 medical procedures

by RugbyFan100 Wed 20 Feb 2019, 2:37 pm

Coach Wayne Pivac has queried the role of independent medical advisors after Scarlets' Pro14 defeat by Benetton.

Scrum-half Kieran Hardy and back-rower Josh Macleod were taken off despite being passed fit by Scarlets medics.

Pivac believes the temporary loss of the players for head injury assessments, complicated by language problems, influenced the score-line.

"To take guys off after ... our guys have checked and cleared him, I find strange," he said.

"HIA's aren't my favourite subject at the moment.

"We'll go through a process with our medical team of reporting it through to the Welsh Rugby Union ... it's information for the powers-that-be to hopefully make improvements for next season."

https://www.bbc.co.uk/sport/rugby-union/47305546

by tigertattie Wed 20 Feb 2019, 4:12 pm

Nah sorry. can't say I have any agreement with Mr Pivac here as if there is even the slighest bit of doubt, the player needs to come off.

Is it a perfect process? no. Are there things like language barriers that could be looked at? Yes.

Welfare needs to come first though and if an independant Doc form Italy says a player is showing signs of concussion, off the player comes. No ifs, no buts.

by LordDowlais Wed 20 Feb 2019, 4:15 pm

tigertattie wrote:Welfare needs to come first though and if an independant Doc form Italy says a player is showing signs of concussion, off the player comes. No ifs, no buts.

Was he an independant doctor ?

Are we saying the Scarlets medical staff are inept ? They did pass them after all.

by lostinwales Wed 20 Feb 2019, 4:44 pm

LordDowlais wrote:
tigertattie wrote:Welfare needs to come first though and if an independant Doc form Italy says a player is showing signs of concussion, off the player comes. No ifs, no buts.

Was he an independant doctor ?

Are we saying the Scarlets medical staff are inept ? They did pass them after all.

If you are talking about fine lines its easier for an independent doctor to be, well, independent and put the player first.

by BamBam Wed 20 Feb 2019, 5:07 pm

If you think you have a serious illness, the first doctor you see says you're fine but the second says I think there may be a problem, do you:

a) assume the 2nd doctor is a moron and continue as normal
b) take caution, and request more medical attention

by Brendan Wed 20 Feb 2019, 8:54 pm

We don't want the situation of George North a few years ago who got knocked out in a game but was cleared to play.
If people give out that their players took hits to the head and that a doctor thinks it could have done damage,well it isn't right. If players pass the HIAs it doesn't mean the doc was wrong, just that they are ok to carry on.
If he puts the loss down to HIAs then maybe Tman was right about him and his coaching ability.

by SecretFly Wed 20 Feb 2019, 9:45 pm

I thought the idea of an independent doctor was to ensure that Team employed medics wouldn't act under duress to the wishes of their employer as defined by an agitated coach wanting procedures glossed over to keep important people on the field?
Here we seem to have a coach who has failed to appreciate the reasoning behind 'Independent'.
These players have lives to lead well past the period when Pivac will be interested in them. For them, caution is by far the best policy.

by LordDowlais Thu 21 Feb 2019, 8:28 am

Look, I am just playing devils advocate here. But we cannot again ignore that the Pro14 has been brought into disrepute over inept organisation and failure to address obvious issues like a language barrier which is a blatant problem that has been overlooked before it could have been easily handled.

But yeah, everything is fine. Rolling Eyes

by maestegmafia Thu 21 Feb 2019, 8:51 am

You would presume in these circumstances that an independent doctor meant just that, that he had no affiliation with either team involved.

by LordDowlais Thu 21 Feb 2019, 9:17 am

maestegmafia wrote:You would presume in these circumstances that an independent doctor meant just that, that he had no affiliation with either team involved.

Except the fact that there was nobody around who could translate Italian into English or vice versa. Rolling Eyes

by carpet baboon Thu 21 Feb 2019, 9:35 am

LordDowlais wrote:
maestegmafia wrote:You would presume in these circumstances that an independent doctor meant just that, that he had no affiliation with either team involved.

Except the fact that there was nobody around who could translate Italian into English or vice versa.

Where did you get that from?

by tigertattie Thu 21 Feb 2019, 9:46 am

LordDowlais wrote:Look, I am just playing devils advocate here. But we cannot again ignore that the Pro14 has been brought into disrepute over inept organisation and failure to address obvious issues like a language barrier which is a blatant problem that has been overlooked before it could have been easily handled.

But yeah, everything is fine.

Wow!!!

"Independent doctor rules on side of caution and advises player welfare is paramount so rules to keep player suspected of concussion from returning to play”

Or

“Coach says Doctor can’t understand English, tells club Medics to clear player suspected of concussion to return to the field of play”

Which headline is bringing the league into disrepute???

by LordDowlais Thu 21 Feb 2019, 9:51 am

tigertattie wrote:
LordDowlais wrote:Look, I am just playing devils advocate here. But we cannot again ignore that the Pro14 has been brought into disrepute over inept organisation and failure to address obvious issues like a language barrier which is a blatant problem that has been overlooked before it could have been easily handled.

But yeah, everything is fine.

Wow!!!

"Independent doctor rules on side of caution and advises player welfare is paramount so rules to keep player suspected of concussion from returning to play”

Or

“Coach says Doctor can’t understand English, tells club Medics to clear player suspected of concussion to return to the field of play”

Which headline is bringing the league into disrepute???

Who is talking about headlines ?

The fact that Pivac is talking about this is bringing the league into disrepute, the fact that we are talking about it is bringing the league into disrepute.

by SecretFly Thu 21 Feb 2019, 10:45 am

I'm all for devil's advocates.... do a bit of that work myself. But Lord, I think you're taking this one too far. You say Pivac bringing up his 'issue' brings the Pro14 into disrepute? Maybe it just brings a future International coach into disrepute? It certainly doesn't reflect badly on the League when an Independent medic shows enough independence to anger a coach. I'd say that's showing a league doing it's duty to player welfare.
Pivac might also be bringing himself into disrepute by implying that had his medics been able to communicate with the independent guy, they would have made him see reason/coaxed him to see reason/tried to influence him.
Pivac might also be bringing himself into disrepute by complaint about the difficulty in dealing with other languages in a PAN NATIONAL league. So the medic had no English? Why did not Pivac, any of his players or backroom people have Italian?
We're in a pan national league. We're privileged as it gives our players a greater awareness of the complexities of International even before any of them get to International. It's a complexity we should cherish and work with. And Pivac should probably just coach and let the medics do their own work and have their own debates. He seems to hint that being cautious with player welfare cheated him out of a game. If that's his intimation then yes, he should be careful about his own reputation not that of the League.

by LordDowlais Thu 21 Feb 2019, 11:49 am

you lot are beauties on here, you really are. If I said today was Thursday you would find some way of trying to prove me wrong, I expect to see some sarcastic reply from SF now on that comment. Rolling Eyes

Was the independant doctor wrong ? Who am I to say, I am not a doctor. But I would not trust a doctor who I could not understand. If a doctor was talking to me in Italian, there is no way on this earth I would know what he is saying is kosha, how could I ?

This just hi-lights more ineptitude. Surely there was somebody there who could have sorted these "language problems" .

We have a cross border competition, where we have countries competing who do not speak the same languages yet the league does not seem overly concerned about it, and it gets complained about when peoples health and safety are concerned.

But yeah everything is great !!!!!!

by tigertattie Thu 21 Feb 2019, 12:16 pm

Last thing I'll say LD is that you are calling us all beauties for disagreeing with you. You say we'll all try and prove you wrong if you said today was Thursday.

Normally if I'm saying something and multiples of people are disagreeing with me, then rather that scoff at them all for being "wrong" I'd take a step back and wonder if perhaps actually I was the one in the wrong.

Unless they are Glasgow fans, in which case they are wrong!

by LordDowlais Thu 21 Feb 2019, 12:27 pm

Would you take the advice off anyone you would not understand tigertattie ?

by tigertattie Thu 21 Feb 2019, 12:35 pm

LordDowlais wrote:Would you take the advice off anyone you would not understand tigertattie ?

If that advice was "you don't appear to be 100% so I suggest you sit out" then yes, damn right I would. I'd then seek medical advice from someone I could understand later on down the line, but at the here and now, I'd do what the doctor tells me.

If you are on holiday and you pass out while on your sun louger and the Doc says "si" points at the sun and then sakes his head and drags you into the shade, while not being entirely sure of his diagnosis, surely you'd stay in the shade and not go back out into the sun???

by **LondonTiger** Thu 21 Feb 2019, 12:37 pm

LordDowlais wrote:Would you take the advice off anyone you would not understand tigertattie ?

Every day, thousands of people see NHS doctors for whom English is not their first language.

Pivac is looking for something and someone to blame. He is the only person bringing the game into disrepute.

by carpet baboon Thu 21 Feb 2019, 12:40 pm

Also if you look through both teams and officials you will find at least 4 that I know off who could have translated to decent enough English.
Just no one asked is my guess.

by RugbyFan100 Thu 21 Feb 2019, 12:44 pm

LondonTiger wrote:

Pivac is looking for something and someone to blame. He is the only person bringing the game into disrepute.

He's not one to complain. He's clearly suggesting, not that the Doctor isn't a competent medical professional, but that the "independent" part of his remit should be called into question.

If a medical professional, like the officials, are suppose to be independent, then maybe, just maybe, they shouldn't be from the same part of the world as one of the teams playing?

Or is that just too ludicrous?

by **LondonTiger** Thu 21 Feb 2019, 12:46 pm

RugbyFan100 wrote:
LondonTiger wrote:

Pivac is looking for something and someone to blame. He is the only person bringing the game into disrepute.

He's not one to complain. He's clearly suggesting, not that the Doctor isn't a competent medical professional, but that the "independent" part of his remit should be called into question.

If a medical professional, like the officials, are suppose to be independent, then maybe, just maybe, they shouldn't be from the same part of the world as one of the teams playing?

Or is that just too ludicrous?

Yes it is too ludicrous.

by carpet baboon Thu 21 Feb 2019, 12:48 pm

RugbyFan100 wrote:
LondonTiger wrote:

Pivac is looking for something and someone to blame. He is the only person bringing the game into disrepute.

He's not one to complain. He's clearly suggesting, not that the Doctor isn't a competent medical professional, but that the "independent" part of his remit should be called into question.

If a medical professional, like the officials, are suppose to be independent, then maybe, just maybe, they shouldn't be from the same part of the world as one of the teams playing?

Or is that just too ludicrous?

Hippocratic oath

by RugbyFan100 Thu 21 Feb 2019, 1:16 pm

LondonTiger wrote:
RugbyFan100 wrote:
LondonTiger wrote:

Pivac is looking for something and someone to blame. He is the only person bringing the game into disrepute.

He's not one to complain. He's clearly suggesting, not that the Doctor isn't a competent medical professional, but that the "independent" part of his remit should be called into question.

If a medical professional, like the officials, are suppose to be independent, then maybe, just maybe, they shouldn't be from the same part of the world as one of the teams playing?

Or is that just too ludicrous?

Yes it is too ludicrous.

Ok. Then these complaints won't go away.

You can't have it both ways I'm afraid.

by BamBam Thu 21 Feb 2019, 1:17 pm

Doctor points at pitch, points at player and makes the universal sign of no by shaking his head

Is that enough of a translation for the Welsh, or do they need it in a more baaaasic form of language?

by RugbyFan100 Thu 21 Feb 2019, 1:19 pm

BamBam wrote:Doctor points at pitch, points at player and makes the universal sign of no by shaking his head

Is that enough of a translation for the Welsh, or do they need it in a more baaaasic form of language?

Yeah, you're not really understanding the issue here are you.

by LordDowlais Thu 21 Feb 2019, 1:20 pm

tigertattie wrote:
LordDowlais wrote:Would you take the advice off anyone you would not understand tigertattie ?

If that advice was "you don't appear to be 100% so I suggest you sit out" then yes, damn right I would. I'd then seek medical advice from someone I could understand later on down the line, but at the here and now, I'd do what the doctor tells me.

If you are on holiday and you pass out while on your sun louger and the Doc says "si" points at the sun and then sakes his head and drags you into the shade, while not being entirely sure of his diagnosis, surely you'd stay in the shade and not go back out into the sun???

But if you cannot understand, then how do you know what they are saying ?

by RugbyFan100 Thu 21 Feb 2019, 1:21 pm

I wonder.......................... if the independent medic in Saturday's Wales v England game, Dr Dai ap Iorwerth from Macynlleth were to asses 6 England players by the 30th minute and declare them all unfit to carry on, we would see a peep out of anybody on the Internet, or Eddie Jones?

by BamBam Thu 21 Feb 2019, 1:24 pm

RugbyFan100 wrote:
BamBam wrote:Doctor points at pitch, points at player and makes the universal sign of no by shaking his head

Is that enough of a translation for the Welsh, or do they need it in a more baaaasic form of language?

Yeah, you're not really understanding the issue here are you.

Lady D is the one banging on about not being able to understand the doctor

by LordDowlais Thu 21 Feb 2019, 1:29 pm

BamBam wrote:Lady D is the one banging on about not being able to understand the doctor

You really are a class act on here aren't you ? Rolling Eyes

I suggest you read the article on the link provided, and in particular this quote:-

Pivac believes the temporary loss of the players for head injury assessments, complicated by language problems, influenced the score-line. wrote:

So no it is not me banging on about it, it is in the topic, so why can't we discuss it ?

by LordDowlais Thu 21 Feb 2019, 1:30 pm

RugbyFan100 wrote:I wonder.......................... if the independent medic in Saturday's Wales v England game, Dr Dai ap Iorwerth from Macynlleth were to asses 6 England players by the 30th minute and declare them all unfit to carry on, we would see a peep out of anybody on the Internet, or Eddie Jones?

Especially if he spoke Welsh, and none of the English could understand what he was going on about. Wink

by BamBam Thu 21 Feb 2019, 1:31 pm

LordDowlais wrote:
BamBam wrote:Lady D is the one banging on about not being able to understand the doctor

You really are a class act on here aren't you ?

I suggest you read the article on the link provided, and in particular this quote:-

So no it is not me banging on about it, it is in the topic, so why can't we discuss it ?

Here we go, this covers my thoughts on the matter

LondonTiger wrote:
LordDowlais wrote:Would you take the advice off anyone you would not understand tigertattie ?

Every day, thousands of people see NHS doctors for whom English is not their first language.

Pivac is looking for something and someone to blame. He is the only person bringing the game into disrepute.

by BamBam Thu 21 Feb 2019, 1:33 pm

RugbyFan100 wrote:I wonder.......................... if the independent medic in Saturday's Wales v England game, Dr Dai ap Iorwerth from Macynlleth were to asses 6 England players by the 30th minute and declare them all unfit to carry on, we would see a peep out of anybody on the Internet, or Eddie Jones?

What if Dr Dai did the same for 6 Welsh players? Does the outcome of his professional opinion make him more or less independent than he was 80 mins earlier?

I'd rather we lost than send 6 players suspected of concussions back out on to the field even if it was dodgy Dr Dai that made that call

by RugbyFan100 Thu 21 Feb 2019, 1:34 pm

BamBam wrote:
RugbyFan100 wrote:I wonder.......................... if the independent medic in Saturday's Wales v England game, Dr Dai ap Iorwerth from Macynlleth were to asses 6 England players by the 30th minute and declare them all unfit to carry on, we would see a peep out of anybody on the Internet, or Eddie Jones?

What if Dr Dai did the same for 6 Welsh players? Does the outcome of his professional opinion make him more or less independent than he was 80 mins earlier?

Dr Dai, hasn't done that.

Dr Giovanni didn't do that.

Unsurprisingly, you couldn't answer the question I asked. Because deep down, you're lying to yourself and you know it.

by BamBam Thu 21 Feb 2019, 1:40 pm

I realised I didn't answer the question, so added it to my post.

I note you didn't answer the question in mine either, before I added my response

Hope this helps

by LordDowlais Thu 21 Feb 2019, 1:41 pm

by RugbyFan100 Thu 21 Feb 2019, 1:42 pm

BamBam wrote:
RugbyFan100 wrote:I wonder.......................... if the independent medic in Saturday's Wales v England game, Dr Dai ap Iorwerth from Macynlleth were to asses 6 England players by the 30th minute and declare them all unfit to carry on, we would see a peep out of anybody on the Internet, or Eddie Jones?

What if Dr Dai did the same for 6 Welsh players? Does the outcome of his professional opinion make him more or less independent than he was 80 mins earlier?

I'd rather we lost than send 6 players suspected of concussions back out on to the field even if it was dodgy Dr Dai that made that call

So you are calling the Doctor "dodgy"?

Interesting.

by BamBam Thu 21 Feb 2019, 1:48 pm

I'm assuming your use of Dr Dai of some Welsh Vale is intended to provoke thoughts of non independence.

I take it back, I would happily lose rather than send 6 players suspected of concussions back on to the field even if it was Dr Dai of said Welsh hole who made the call

If that same Dr Dai of some Welsh hole did the same with 6 Welsh players, is he more or less independent than he was when he was appointed to be the independent doctor?

by RugbyFan100 Thu 21 Feb 2019, 1:54 pm

BamBam wrote:l

If that same Dr Dai of some Welsh Vale did the same with 6 Welsh players, is he more or less independent than he was when he was appointed to be the independent doctor?

He's the same level of indepndency. Which is 0%. Because he's not independent.

by BamBam Thu 21 Feb 2019, 2:15 pm

So you think a qualified medical professional would falsely diagnose someone because of the rugby team they play for. Right

by **LondonTiger** Thu 21 Feb 2019, 2:19 pm

So long as he is neither employed by WRU or RFU he is completely independent, nationality is irrelevant. Even if he was I would demand that said Doctor applied his medical knowledge independently of any pressure applied to him.

I am with Bam Bam - if the assigned medic states a player is not fit to go back onto the field then he should not go back on. If we then lose it is because the players on the pitch were unable to match the opposition.

by LordDowlais Thu 21 Feb 2019, 2:21 pm

LondonTiger wrote:So long as he is neither employed by WRU or RFU he is completely independent, nationality is irrelevant. Even if he was I would demand that said Doctor applied his medical knowledge independently of any pressure applied to him.

I am with Bam Bam - if the assigned medic states a player is not fit to go back onto the field then he should not go back on. If we then lose it is because the players on the pitch were unable to match the opposition.

But Pivac is not saying that is he ?

He is saying because of the language barrier his medics, and the independent doctor got their wires crossed and his players were refused to come back on. What a complete shambles.

by RugbyFan100 Thu 21 Feb 2019, 2:21 pm

BamBam wrote:So you think a qualified medical professional would falsely diagnose someone because of the rugby team they play for. Right

I believe that is what Wayne Pivac is hinting at yes.

But it's more exaggerating the symptoms than falsely diagnosing someone. It's a real extenuating circumstance - because there would never be any come back on the doctor - as he or she would be able to say "I was operating a zero tolerance approach to head knocks in this circumstance".

There is absolutely no way Pivac is moaning about this because he's in a bad mood about it. He would have spoken at length to his own physios and the condition of the players involved.

by **LondonTiger** Thu 21 Feb 2019, 2:24 pm

LordDowlais wrote:
LondonTiger wrote:So long as he is neither employed by WRU or RFU he is completely independent, nationality is irrelevant. Even if he was I would demand that said Doctor applied his medical knowledge independently of any pressure applied to him.

I am with Bam Bam - if the assigned medic states a player is not fit to go back onto the field then he should not go back on. If we then lose it is because the players on the pitch were unable to match the opposition.

But Pivac is not saying that is he ?

He is saying because of the language barrier his medics, and the independent doctor got their wires crossed and his players were refused to come back on. What a complete shambles.

That is not how I read his comments, nor how RF100 is.

by LordDowlais Thu 21 Feb 2019, 2:26 pm

LondonTiger wrote:
LordDowlais wrote:
LondonTiger wrote:So long as he is neither employed by WRU or RFU he is completely independent, nationality is irrelevant. Even if he was I would demand that said Doctor applied his medical knowledge independently of any pressure applied to him.

I am with Bam Bam - if the assigned medic states a player is not fit to go back onto the field then he should not go back on. If we then lose it is because the players on the pitch were unable to match the opposition.

But Pivac is not saying that is he ?

He is saying because of the language barrier his medics, and the independent doctor got their wires crossed and his players were refused to come back on. What a complete shambles.

That is not how I read his comments, nor how RF100 is.

Again I refer to this quote, what would you take this as meaning then ?

Pivac believes the temporary loss of the players for head injury assessments, complicated by language problems, influenced the score-line. wrote:

by **LondonTiger** Thu 21 Feb 2019, 2:29 pm

RugbyFan100 wrote:
BamBam wrote:So you think a qualified medical professional would falsely diagnose someone because of the rugby team they play for. Right

I believe that is what Wayne Pivac is hinting at yes.

But it's more exaggerating the symptoms than falsely diagnosing someone. It's a real extenuating circumstance - because there would never be any come back on the doctor - as he or she would be able to say "I was operating a zero tolerance approach to head knocks in this circumstance".

There is absolutely no way Pivac is moaning about this because he's in a bad mood about it. He would have spoken at length to his own physios and the condition of the players involved.

I trust the doctor more than I trust his physios to do 100% the right thing and err on the side of caution. We have seen far too many club employed officials ignore medical common sense in the heat of the moment - most noticeably with George North when playing for Wales and Northampton.

Pivac also moaned about HIAs in general not just specifically in this match, but by bringing it up only after his team has lost it looks just like yet another sporting coach deflecting blame for an unexpected defeat.

by Mad for Chelsea Thu 21 Feb 2019, 2:30 pm

I think LD is extrapolating a lot from the statement "complicated by language problems", which as far as I can tell doesn't refer to a direct quote from Pivac in the article.

Reading just what Pivac said, he's unhappy his players were told to come off by the independent medics after the Scarlets medics had cleared them. But that's surely the point of having medics who are independent, i.e. they can make decisions without the same pressure. So for me this is a good example of the system working (mostly) as it should.

by The Great Aukster Thu 21 Feb 2019, 2:33 pm

Pivac et al DID understand the Doctor, but they didn't agree with his diagnosis. Were the medics employed by the Scarlets better qualified than the independent match doctor? What about the Benetton medical staff should their professional opinions have been sought as well!

Wayne Pivac questioning a medical expert's opinion reveals enough about his own integrity that the WRU may be wondering whether they have backed the right horse.

by **LondonTiger** Thu 21 Feb 2019, 2:35 pm

LD wrote:
LondonTiger wrote:

LordDowlais wrote:

LondonTiger wrote:So long as he is neither employed by WRU or RFU he is completely independent, nationality is irrelevant. Even if he was I would demand that said Doctor applied his medical knowledge independently of any pressure applied to him.

I am with Bam Bam - if the assigned medic states a player is not fit to go back onto the field then he should not go back on. If we then lose it is because the players on the pitch were unable to match the opposition.

But Pivac is not saying that is he ?

He is saying because of the language barrier his medics, and the independent doctor got their wires crossed and his players were refused to come back on. What a complete shambles.

That is not how I read his comments, nor how RF100 is.

Again I refer to this quote, what would you take this as meaning then ?

Pivac believes the temporary loss of the players for head injury assessments, complicated by language problems, influenced the score-line.

So two comments with really very different meanings. He does not say language problems (and if I were being Devil's advocate why shoul dteh Doctor speak Welsh?) caused the issue, but that the withdrawal of the players for a temporary loss (meaning they could come back on) was complicated by the language barrier.

by RugbyFan100 Thu 21 Feb 2019, 2:40 pm

LondonTiger wrote:
RugbyFan100 wrote:
BamBam wrote:So you think a qualified medical professional would falsely diagnose someone because of the rugby team they play for. Right

I believe that is what Wayne Pivac is hinting at yes.

But it's more exaggerating the symptoms than falsely diagnosing someone. It's a real extenuating circumstance - because there would never be any come back on the doctor - as he or she would be able to say "I was operating a zero tolerance approach to head knocks in this circumstance".

There is absolutely no way Pivac is moaning about this because he's in a bad mood about it. He would have spoken at length to his own physios and the condition of the players involved.

I trust the doctor more than I trust his physios to do 100% the right thing and err on the side of caution. We have seen far too many club employed officials ignore medical common sense in the heat of the moment - most noticeably with George North when playing for Wales and Northampton.

.

And I trust that Pivac believes that there is more to the story.

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