Goal Play! is all about how lessons from soccer spill over into corporate and institutional settings.  I am not the first or only person to notice that.  There is a great article in The Guardian about medicine and soccer refereeing, written by Dr. Stuart Lewis, an internist in New York City, entitled “How refereeing soccer made me a better doctor.”  The subtitle is “Doctors are deeply invested in the myth of their infallibility. Once I began refereeing my son’s league, I saw the error of my ways.”  Excerpts:

This is the time of year I get ready to precept a group of third-year medical students. We have four weeks together on the medicine wards, and while they constantly worry about the facts, I worry about how they think. Teaching my students clinical reasoning means helping them harness their most powerful diagnostic tool – their ability to communicate effectively and compassionately. Better communication not only betters health, especially for people with chronic illnesses, but also makes doctoring more satisfying.

Medical schools have developed a host of innovative programs to improve this skill, but as far as I know, none has proposed my fantasy solution – asking students to trade their white coats and stethoscopes for striped shirts and whistles, so they can referee soccer. Though this may seem strange, I have learned over the years that good refereeing is a lot like good medicine.

A game is alive; it is moving and pulsating, and there is the ever-present danger of injury. In the midst of all this is the referee, singularly bestowed with the duty to “enforce the laws of the game”. Some of the laws are direct and quantifiable… Others, as when, precisely, does a player in an offside position become active, are delphically abstruse. Most are neither, but all require constant vigilance and split-second judgments.

The art of refereeing, like the art of medicine, requires not just a thorough knowledge of the laws but the craft to intervene wisely…. While the laws cede us full authority, they also prescribe that, during play, our status is the same as a goal post. The referee is part of the field, in service to the players who are there to have safe, competitive fun.

Doctors and referees must also continually balance authority, the right to order and be obeyed, with autonomy, the right of a patient, player or spectator to do what they wish.

Clear communication and respect helps, at least until the first mistake. A mistake changes everything.

As a rule, we doctors do not embrace mistakes naturally. Our training deifies perfection, and I see that my students are its newest disciples well before they have even touched their first patient. Mistakes seed shame and defensiveness that crystallize into arrogance, transforming the doctor from ally to adversary. Add to this the way the most vulnerable often need to believe that their doctors are infallible, and suddenly, mistakes become cataclysmic.

Refereeing has been my laboratory for learning how to uncouple fallibility from failure.

So, this year, though I won’t take my students onto the pitch, one goal of mine will be to make them better at making mistakes, too.