The starting point for this debate is Gérard Guillaume, who is putting his foot in his mouth. His requirement is quite radical : no profit sharing, no performance bonuses. Doctor of team, referring doctor of MPCC, he exposes his views with conviction : he believes that only the health control of the riders should concern him and that participate in the optimization of the training is incompatible with medical ethics. A point of view on which we have been collecting his colleagues’ feedback (see below). So, what do YOU think ?


The interview with Gérard Guillaume, doctor :





Prentice Steffen, doctor of team Garmin-Sharp, tempered Gérard Guillaume’s position while emphasizing the importance of trust, which must be consolidated with a doctor who has an expertise in physiology. Nevertheless, he joined Gérard Guillaume on the question of performance bonuses, which are also expressly prohibited by the UCI regulations.


The interview with Prentice Steffen, Garmin-Sharp doctor : 





According to Eric Bouvat, doctor of the team AG2R La Mondiale, a physician with expertise in training may be more effective in this field because he will think of the health prevention. He considers the the problem arises when you have the two functions.


The interview with Eric Bouvat, AG2R La Mondiale doctor :



The transcript of the interview :


“According to our curriculum and our expertise, we visit our patients, because they are our patients, for me they are all patients even if they are athletes, we visit our patients to express our skills. I am not a specialist in dermatology, so when I have a problem, I call a friend who is a dermatologist. So I don’t get why, because you’re a doctor, you could not participate in training. That’s it. Nevertheless, make the two becomes problematic. Can we be the doctor of the athletes and both their coach. It is a matter of debate. It is not as clear-cut as that, if the doctor respects the rule of 100% of the capacity of people, he surely may be effective in training and maybe even more effective because he will think of health prevention in the quantity of training he is going to propose. And regarding the injury prevention, he’ll be even more likely to prevent injury than a coach could be.”



Reflection of Anko Boelens, the Dutch team doctor of Giant-Shimano, focuses on the difficulty of defining what we really mean by medicine of performance. He takes the example of paracetamol, which treats the pain and discomfort, but might be counted as a performance drug if it’s taken “just in case”. 


The interview with Anko Boelens, Giant-Shimano doctor :


“Performance medication is a very grey area. Where does it start, where does it end ? Sometimes it is easy : for instance EPO is always a performance medicine, and should therefore always be banned. But what for instance about a paracetamol ? Riders will feel discomfort during races, so they might take two paracetamol during the race. Is this performance medicine ? I think medication that serves only one purpose – to make a rider go faster – can be called a performance medicine.


In the example I gave before, paracetamol would not be called a performance medication because it counters pain and discomfort. However if they would always take it just in case, it might be called performance medication and riders who do such a thing should be discouraged to do so. On a more practical sidenote, medication that might have sight effects or when it is not known if there are side-effects, is in my opinion always a no-go. Tramadol is a very fine example. It might be responsible for more accidents during the race and can therefor not be tolerated.


And finally, I absolutely agree that the medical staff should never receive performance bonuses. As a doctor you are charged with two things : to make sure your riders stay in the best health possible, and that once they are sick or injured that get well. Making them go faster is not a direct goal, you try to make the team a better team trying your best to keep everyone fit. This I think can not be measured by the number of victories a team gets, so as a doctor you should not expect a bonus.”