In the current era, there is an increasing focus on the role of medical and other healthcare professionals in sport. In a high performance environment where results are critical and margins are everything, significant pressure can be placed on the team doctor to ensure that a player is match fit or an athlete is able to race. The doctor's duties are to the athlete as their patient, not to a coach, manager or performance director. Organisations need to consider the structure that a team doctor sits in and who they are answerable to in terms of line management and ultimate professional accountability. For large organisations, there are obvious benefits in separating out the provision of primary care medical services and medical performance support.