Medical care delivery in international football: perceived best practice and challenges. An interview-based study of national team clinicians

The objective of this study was to describe the experiences of clinicians working within the top 50 FIFA ranked senior men's and women's international football teams regarding (i) feasible best practice in delivering medical care and (ii) the related challenges. A qualitative study was conducted by means of semi-structured interviews. Participants were clinicians from seven men's and five women's FIFA top-50 ranked international football teams, including nine doctors and three physiotherapists. Data analysis applied thematic analysis utilising a pragmatic realist stance. The results of this study are represented by five main themes: (1) communication and relationships, (2) governance, (3) navigating risk-taking, (4) delivering medical care abroad, and (5) resource impact. Concepts relating to clinician-perceived best practice included building relationships with technical staff members, effective communication, and relationships with club medical teams, adherence to practices such as medical screening and emergency scenario preparation, maintaining consent and confidentiality, shared decision-making with players, logistically planning for travel, and supporting staff psychological wellbeing. Challenges included conflict with technical staff and club medical teams, unsatisfactory handovers, club agendas, risk-taking approaches, travel, resource limitations in women's football and staff wellbeing. Clinician experiences of best practice and challenges in the context of medical care in international football have been identified in this study. These findings provide practice-informed insights that may guide improvements in international football medicine.