Phlebotomists as team docs

[sniper]

going through Dr. Carlos Gonzalez Haro's (physiologist of Garmin) CV, i noticed that as of 2009 he's a licensed Phlebotomist.

from Wikipedia:

Phlebotomists are people trained to draw blood from a live person or animal for tests, transfusions, donations, or research.

A quick and objective question I wanted to ask here is whether it is common among, and/or necessary for, cycling teams to have a phlebotomist on board (for reasons other than doping, that is!)? I know many of the anti-doping sample collectors are phlebotomists, but is that a common/necessary expertise also among team docs?

More generally, how common is the withdrawal of blood from pro-cyclists (for non-doping purposes, NB) during training periods? Do they withdraw blood on a daily basis? On a weekly basis? Is it merely to monitor the influence and effects of altitude training or are there other purposes? And, is it really necessary to check hematocrit levels if you're not doping? (Recall Bassons' claim that in principle one doesn't really need team doctors if one is clean.)

For those interested, I found this abstract from a 1997 article where phlebotomy is (for the sake of their argument, I assume) equated with "blood doping". I think the full article is downloadable on that website.

The effect of reinfusion of autologous blood (1350 ml) on exercise time over a specified distance (approx. 15 km) 4 weeks after phlebotomy ("blood doping") were investigated in six well-trained cross-country skiers. An additional control group of six well-trained skiers was included in the study. Test races were performed before phlebotomy, 3 h after, and 14 days after reinfusion of blood. In each test race, the mean time of the control group was set to 100% and the time of the blood-doped subjects expressed in percentage of the control group mean time. In the first control race, the mean time of the subjects who were later "blood doped" was 99.4% of the control group. However, both 3 h and 14 days after the reinfusion of autologous blood, the mean time of the blood-doped subjects was significantly lower (94.1%; P less than 0.05; 96.3%, P less than 0.05, respectively) than the control group. In conclusion, reinfusion of autologous blood stored in a refrigerator for 4 weeks after phlebotomy significantly increased performance expressed as race time in cross-country skiers. The significantly increased performance was observed both 3 h and 14 days after reinfusion. http://www.ncbi.nlm.nih.gov/pubmed/3623787

 

[Cavalier]

A Phlebotomist is normally only required for larger amounts of blood - not the pin-*** that cycling teams should be doing simply for data. That's a bit odd to say the least.

e: Phlebotomists draw blood from the veins. That's really odd.

 

[acoggan]

going through Dr. Carlos Gonzalez Haro's (physiologist of Garmin) CV, i noticed that as of 2009 he's a licensed Phlebotomist.

from Wikipedia:


A quick and objective question I wanted to ask here is whether it is common among, and/or necessary for, cycling teams to have a phlebotomist on board (for reasons other than doping, that is!)? I know many of the anti-doping sample collectors are phlebotomists, but is that a common/necessary expertise also among team docs?

More generally, how common is the withdrawal of blood from pro-cyclists (for non-doping purposes, NB) during training periods? Do they withdraw blood on a daily basis? On a weekly basis? Is it merely to monitor the influence and effects of altitude training or are there other purposes? And, is it really necessary to check hematocrit levels if you're not doping? (Recall Bassons' claim that in principle one doesn't really need team doctors if one is clean.)

For those interested, I found this abstract from a 1997 article where phlebotomy is (for the sake of their argument, I assume) equated with "blood doping". I think the full article is downloadable on that website.

I know nothing about the medical system in Spain. It could be, though, that since he's a physiologist and not a physician that he needs (or has) a special certification to draw blood even for innocent things such as lactate testing.

For example, here in the US I know of colleagues who have obtained CLIA certification (or have hired techs with CLIA certification) because it makes it easier to obtain approval from IRBs for research studies.

EDIT: I suppose another possibility is that he picked up the phlebotomist certification for some non-cycling/non-doping related reason, and has simply kept it active in case he ever wanted to go back to that activity.

 

[taiwan]

^ yup. From a layman's point of view, this is just a qualification the guy has. It does not prove that he's working as a phlebotomist @ Garmin although it does mean they have someone on the books who could do or be consulted about transfusions. I mean it's a good spot, but not to jump the gun.

 

[hiero2]

I can think of reasons why it might be legit. I'm not saying these ARE the reasons, as I do not know, but from what I do know, they might be.

* Given the large amounts of money now devoted to the sport, a rider's health, and taking care of it, becomes financially more important to the team. As an aspect of taking care of the rider's health, regular blood draws might be done for tests for illness.
* Regular testing might also be done to keep an eye on physical markers in the blood to watch for how the rider's body is responding to physical stress. This could be useful in judging fatigue, or for advance notice that somebody is responding poorly in a GT. (Is he really tired, or is it just a temporary thing?)
* If you've got med staff on hand, it would be convenient to be able to draw blood samples without having to send the rider somewhere else to get it done. No "Fred, run down to town tomorrow and see if you can find some clinic to draw some samples and send them to the lab for testing".
* When you are a small organization, having someone on staff with multiple skills is generally more useful than having very specialized individuals. Every team, even the big ones, are still small businesses, not big businesses.

Oh, and btw, I think the use of "phlebotomy" in that paragraph is poor usage, and somewhat misleading. I do not think they intended to equate phlebotomy with autologous blood doping. They DID have the same difficulty that all authors do in scientific studies - how to say ACCURATELY what you mean, and at the same time in such a way that it can not be misinterpreted by the audience, AND at the same time, in words that your scientific community will accept and respect! It is far harder than it might seem! The scientific community likes buzzwords and phrases that keep out the public riff-raff (doc speak, if you will), and yet you want people to understand exactly what happened. You have to condense all that into a single paragraph or at most two, into what is called the abstract. In the corporate world, this would be similar to the executive summary. You have to put a lot of work into 100 words or less. Of course, I could be wrong, they might have meant to equate the two, but I don't think so.

 

[sniper]

thanks Cavalier, acoggan, taiwan and hiero2, for the excellent infos.
I fully agree of course, there is nothing here to suggest he uses his phlebotomist expertise to dope riders.

I can think of reasons why it might be legit. I'm not saying these ARE the reasons, as I do not know, but from what I do know, they might be.

* Given the large amounts of money now devoted to the sport, a rider's health, and taking care of it, becomes financially more important to the team. As an aspect of taking care of the rider's health, regular blood draws might be done for tests for illness.
* Regular testing might also be done to keep an eye on physical markers in the blood to watch for how the rider's body is responding to physical stress. This could be useful in judging fatigue, or for advance notice that somebody is responding poorly in a GT. (Is he really tired, or is it just a temporary thing?)
* If you've got med staff on hand, it would be convenient to be able to draw blood samples without having to send the rider somewhere else to get it done. No "Fred, run down to town tomorrow and see if you can find some clinic to draw some samples and send them to the lab for testing".
* When you are a small organization, having someone on staff with multiple skills is generally more useful than having very specialized individuals. Every team, even the big ones, are still small businesses, not big businesses.

Oh, and btw, I think the use of "phlebotomy" in that paragraph is poor usage, and somewhat misleading. I do not think they intended to equate phlebotomy with autologous blood doping. They DID have the same difficulty that all authors do in scientific studies - how to say ACCURATELY what you mean, and at the same time in such a way that it can not be misinterpreted by the audience, AND at the same time, in words that your scientific community will accept and respect! It is far harder than it might seem! The scientific community likes buzzwords and phrases that keep out the public riff-raff (doc speak, if you will), and yet you want people to understand exactly what happened. You have to condense all that into a single paragraph or at most two, into what is called the abstract. In the corporate world, this would be similar to the executive summary. You have to put a lot of work into 100 words or less. Of course, I could be wrong, they might have meant to equate the two, but I don't think so.

In Garmin's favor, one could add to those 4 points that by having a phlebotomist on board they can better monitor whether their riders aren't secretly doping themselves with help from outside.

anyway, good post thanks
i agree also with the last paragraph.

 

[hiero2]

. . .In Garmin's favor, it could even be argued that by having a phlebotomist on board they can better monitor whether their riders aren't secretly doping themselves with help from outside.
. . .

Good point. I forgot about that.

 

[Fearless Greg Lemond]

In Garmin's favor, one could add to those 4 points that by having a phlebotomist on board they can better monitor whether their riders aren't secretly doping themselves with help from outside.

Wouldn't a normal hematologist, uh sports doctor nowadays, be able to do that?

http://www.sligochampion.ie/lifesty...eal-madrid-fc-to-sligo-heres-how-3127913.html

The company for which Carlos works in Sligo, ORRECO, has developed a high tech blood and saliva testing technique that helps athletes reach peak performacne, protects sports men and women from overtraining syndrome and helps reduce the number of days lost to illness and infection.

They recently signed a contract with the Irish Institute of Sport, and will work with the cream of Ireland's high performance athletes, icluding many of those who will represent the country at the London Olympics this summer.

Among those with whom Carlos and his colleagues have already worked include golfer, Padraig Harrington, athletes Paula Radcliffe, Mo Farah and Fionnuala Britton, the Nike Oregon Track Club and the British Olympic Sailing Squad.

Given the results of the bold parts they must be doing something right there in Ireland.

The guy specializes in overtraining apparently, interesting name at Orecco: Robin Parisotto, one of the EPO detection guys from Australia.

 

[the big ring]

In Garmin's favor, one could add to those 4 points that by having a phlebotomist on board they can better monitor whether their riders aren't secretly doping themselves with help from outside.

The ABP is the paragon of testing methodologies / practices and I find it entirely offensive that you would suggest anything other than the ABP is required to maintain the UCIs coffers er I mean clean up the sport and maintain a level playing field.

Your point above is wild conjecture, I believe.

It's not doping if the product is not on WADA's list.

 

[hiero2]

Wild conjecture? Huh? Big Ring, you lost me. I think you must be using irony, that always loses me.

 

[GJB123]

I think more accurately it is a team doctor who also happens to have qualifications as a phlebotomist. Given how conniving some people here think JV is, it would be pretty darned stupid to hire someone and then tell everyone he is phlebotomist. He would have been much better off hiring a gynecologist according to you guys.

Regards
GJ

 

[sniper]

I think more accurately it is a team doctor who also happens to have qualifications as a phlebotomist. Given how conniving some people here think JV is, it would be pretty darned stupid to hire someone and then tell everyone he is phlebotomist. He would have been much better off hiring a gynecologist according to you guys.

Regards
GJ

Note though that he obtained his phlebotomist licence in 2009, which happens to be the year in which Garmin hired him. Not saying there is a correlation. There could be though.
(of course, even if there is a correlation, it needn't be explained in terms of doping or anti-doping. As hiero2 pointed out, there are different reasons why a phlebotomist could be of use to a cycling team)

 

[the big ring]

Wild conjecture? Huh? Big Ring, you lost me. I think you must be using irony, that always loses me.

Forgive me, I just got off a plane flight that lasted a day and a half. 1st sentence was sarcasm. 2nd sentence was honest. 3rd was conspiracy theory.

To reiterate:

I am severely jaded with professional cycling, and tired.

JV craps on about the ABP and how it is working, and cleaning up the peloton and leveling the playing field. As I said, I am tired, and may have this completely wrong, but I believe that is what he is claiming. Hence one of his riders - Ryder - can win the Giro, clean. (It is my theory JV was instrumental in setting the ABP up and hence why he defends it so well but yeah, that's wild conjecture on my part).

Now someone is trying to say JV hired a doctor, who is also a phlebotomist, and that is another point in JV's favour, because it allows them to potentially spot someone on the team doping, independently, before / instead of the ABP.

My take: we have 2 scenarios:

1. ABP works. Why the hell would you need your own in-house anti-doping control testing then?
2. ABP doesn't work. Why the hell would you say it was, and point to your team winning the Giro clean in the process / as proof.

It's wild conjecture to suggest that Garmin have in-house testing, given JV's statements on ABP.

I'm not a blind fanatic of JV's and am just calling BS on people making stuff up in his favour when in my mind if it were true it would make him look like a liar. Especially when we have evidence pointing to no internal testing going on at Garmin.

ETA: keep in mind - doping testing is BLOODY expensive, and Garmin, as PT team, already pay squillions to UCI for the pleasure of being on the ABP.

 

[sniper]

Forgive me, I just got off a plane flight that lasted a day and a half. 1st sentence was sarcasm. 2nd sentence was honest. 3rd was conspiracy theory.

To reiterate:

I am severely jaded with professional cycling, and tired.

JV craps on about the ABP and how it is working, and cleaning up the peloton and leveling the playing field. As I said, I am tired, and may have this completely wrong, but I believe that is what he is claiming. Hence one of his riders - Ryder - can win the Giro, clean. (It is my theory JV was instrumental in setting the ABP up and hence why he defends it so well but yeah, that's wild conjecture on my part).

Now someone is trying to say JV hired a doctor, who is also a phlebotomist, and that is another point in JV's favour, because it allows them to potentially spot someone on the team doping, independently, before / instead of the ABP.

My take: we have 2 scenarios:

1. ABP works. Why the hell would you need your own in-house anti-doping control testing then?
2. ABP doesn't work. Why the hell would you say it was, and point to your team winning the Giro clean in the process / as proof.

It's wild conjecture to suggest that Garmin have in-house testing, given JV's statements on ABP.

I'm not a blind fanatic of JV's and am just calling BS on people making stuff up in his favour when in my mind if it were true it would make him look like a liar. Especially when we have evidence pointing to no internal testing going on at Garmin.

ETA: keep in mind - doping testing is BLOODY expensive, and Garmin, as PT team, already pay squillions to UCI for the pleasure of being on the ABP.

to be sure, I was saying the hiring of a phlebotomist can be explained in Garmin's favor (i.e. JV can claim it was an anti-doping measurement). But that's not necessarily why i personally think he's on board. Like you, I'm a big skeptic of JV's clean talk, and not a great fan of his marginal gains philosophy either.

And it shouldn't be a secret that I'm rather skeptic of the good intentions of our Garmin (ex)docs Lim, San 'Astana' Millán and Carlos 'Real Madrid' Gonzalez Haro.

 

[luckyboy]

Any phlebotomists on other teams or is this just another thread about Garmin?

 

[the big ring]

to be sure, I was saying the hiring of a phlebotomist can be explained in Garmin's favor (i.e. as an anti-doping measurement). But that's not necessarily why i personally think he's on board. Like you, I'm a big skeptic of JV's clean talk, and not a great fan of his marginal gains philosophy either (that's an understatement).

I like how there's all these "reasons" why doctors are on the teams - from saddle sores that kill soigneurs to bad teeth and hot weather and anti-doping.

There's not that many places where doctors need to be for cyclists - Leindeers isn't even at the tours for Sky.

Let's pool all pro team doctor budgets and have a pool of doctors in each country the teams can go to - level the playing field, so to speak.

Have a couple at Tenerife, coz lots of riders go there.

I say remove the marginal gain your team doctor provides, as it should only be about rider health, and all riders should get the best care there is available.

No more team doctors. Level the playing field. Look after the riders equally.

 

[the big ring]

Any phlebotomists on other teams or is this just another thread about Garmin?

I'm sorry you don't believe in phlebotomy.

 

[sniper]

I'm sorry you don't believe in phlebotomy.

Any phlebotomists on other teams or is this just another thread about Garmin?

This was indeed something i was also curious about (see OP).

 

[sniper]

I like how there's all these "reasons" why doctors are on the teams - from saddle sores that kill soigneurs to bad teeth and hot weather and anti-doping.

There's not that many places where doctors need to be for cyclists - Leindeers isn't even at the tours for Sky.

Let's pool all pro team doctor budgets and have a pool of doctors in each country the teams can go to - level the playing field, so to speak.

Have a couple at Tenerife, coz lots of riders go there.

I say remove the marginal gain your team doctor provides, as it should only be about rider health, and all riders should get the best care there is available.

No more team doctors. Level the playing field. Look after the riders equally.

(I'm laughing but they really are interesting points to consider.)

 

[sniper]

I like how there's all these "reasons" why doctors are on the teams - from saddle sores that kill soigneurs to bad teeth and hot weather and anti-doping.

There's not that many places where doctors need to be for cyclists - Leindeers isn't even at the tours for Sky.

Let's pool all pro team doctor budgets and have a pool of doctors in each country the teams can go to - level the playing field, so to speak.

Have a couple at Tenerife, coz lots of riders go there.

I say remove the marginal gain your team doctor provides, as it should only be about rider health, and all riders should get the best care there is available.

No more team doctors. Level the playing field. Look after the riders equally.

+5
(or +10, considering you're suffering a jetlag)

 

[GJB123]

Note though that he obtained his phlebotomist licence in 2009, which happens to be the year in which Garmin hired him. Not saying there is a correlation. There could be though.
(of course, even if there is a correlation, it needn't be explained in terms of doping or anti-doping. As hiero2 pointed out, there are different reasons why a phlebotomist could be of use to a cycling team)

No oh no, you haven't said or suggested anything. Starting this thread was obviously just to get the discussion on JV flowing, because we haven't had any discussions on him lately. By God, my sincere apologies if you have taken my post as to imply that you are suggesting anything untoward or have any preconceived ideas regarding doping and any doping allegations or rumors. We couldn't have that now, could we?

Regards
GJ

 

[sniper]

No oh no, you haven't said or suggested anything. Starting this thread was obviously just to get the discussion on JV flowing, because we haven't had any discussions on him lately. By God, my sincere apologies if you have taken my post as to imply that you are suggesting anything untoward or have any preconceived ideas regarding doping and any doping allegations or rumors. We couldn't have that now, could we?

Regards
GJ

Indeed, I have preconceived ideas about doping in pro-cycling. If you don't, that can only mean that you haven't been paying much attention in the last 10 to 15 years.

 

[GJB123]

Indeed, I have preconceived ideas about doping in pro-cycling. If you don't, that can only mean that you haven't been paying much attention in the last 10 to 15 years.

Then why bother calling out JV then? You already have all the answers don't you, assuming you have been paying attention the last 10-15 years?

 

[rickshaw]

Joe would be proud a ya...

I used to be a member of the "International Quick Time Virtual Reality Association", the IQTVRA, as it was called. What does that make me? What does that mean? (Virtually nothing?)

Frankly this sounds like a page from the Joe McCarthy training manual.

"Are you now, or have you ever been a member of the Communist Party?"

 

[sniper]

Then why bother calling out JV then? You already have all the answers don't you, assuming you have been paying attention the last 10-15 years?

no, i don't have all the answers. but neither do i see any reason to give JV the benefit of the doubt like many back then were giving Lance and Bruyneel the benefit of the doubt. There are too many parallels. In fact, I currently see no indications whatsoever that suggest JV's Garmin is clean. He's claiming Sky is clean fcol, and is using the same rethorics as Lance and Bruyneel used to sell us and fully in line with Brailsford. Give me one reason why JV or his doctors deserve the benefit of the doubt? Because he says so? Give me something tangible (other than Kimmage's 2008 internship please, cuz that's outdated). And while you're at it, try addressing and accounting for some of the extreme dodginess surrounding the Clean Team (the Bruyneel-link, the Contador-link, the Girona-link, the Spanish-docs-link, the marginal-gains-talk, the Sky-is-clean-claim, etc.)

More to the point: do you think Sky is clean?