The AFL’s medical substitute rule remains one of the game’s most controversial less than two years into its implementation.

While far from the only example, Richmond’s decision to sub Ben Miller out midway through the last term of last week’s draw against Fremantle was met with skepticism from a large portion of footy fans, even though it has since been ticked off by the league and Miller named in the club’s round 20 side.

So, where do things sit ahead of 2023 and potentially a much-needed refinement of the rule?

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From a players standpoint, a growing contingent are in favour of the medical substitute rule being altered, with fears the current version of it can be “gamed” by clubs too easily.

“It’s fair to say players have expressed concerns similar to that of the doctors’ association that the sub rule does put some undue pressure on the doctors and at least has the potential to be gamed,” AFL Players’ Association GM of Player and Stakeholder Relations Brett Murphy told foxfooty.com.au.

“They do believe it’s something worth looking at, even if they don’t at the moment have a precise formulation as to how it could be done differently.”

It’s worth noting the league, at the outset of the rule’s formulation, looked to introduce a mandatory 12-day lay-off for every player subbed off, but the kybosh was quickly put on that idea by the AFLPA.

Should the league try once again to implement a mandatory 12-day lay-off - regardless of a club doctor clearing them during the week - the response will be swift from the AFLPA.

“We’d be categorically against that,” Murphy told foxfooty.com.au.

“You only need to look at the concerns that the doctors have raised this week (via the Herald Sun) that they’re feeling under pressure about it.

“That probably legitimises our concern around the potential of gaming it and then if that is the case, why should the player who’s been subbed off without it being due to a serious injury, they’re probably not that happy with it to begin with, to then force them to miss a week is just unacceptable.

“That’s not just in situations where there’s the possibility of it being gamed … there are examples this year such as Jeremy Cameron who genuinely wouldn’t have been taken off unless it was necessary, he went to hospital, but he was right to play the next week.”

From the AFLPA’s standpoint, a 12-day mandate could make clubs almost too conservative with their sub, discouraging clubs from removing the player if they’re in a touch-and-go situation to keep playing.

As the appetite for change to the sub rule has grown for AFL fans, so too has it grown for those within clubs.

Most players appear in favour of a change, but even coaches are beginning to voice a desire for change in the rule.

Opening the rule up to be a pure tactical sub is one of several options that could be considered.

“I think that should be considered. If you lost a player and only had four on the interchange that‘s too much of a disadvantage,” Sydney Swans coach John Longmire said this week.

“It wouldn‘t worry me if it was just a five (on the interchange) or a straight sub and you went back to that.”

It should come as no surprise Longmire’s contemporary, Western Bulldogs coach Luke Beveridge, is less than satisfied with the current state of the rule, given his track record with voicing concerns publicly regarding edicts from AFL House.

“If we think we need one as a buffer for concussion, (then) don’t make it a sub but just say you’ve got five on the interchange and you can use them if you want,” Beveridge said.

“It will add a bit of tactical intrigue. As I said back then – and I did promote it, as far as what I had to say at the table, when the AFL asked – I’m not going to circulate five players during the game.

“Four’s almost one too many, anyway, so you’re likely going to sit one down until you really need that player, but you could introduce that player for a quarter here and there and it creates a different angle.

“But all it does is it removes all the red tape and we don’t have to explain ourselves if you take a player out of the game and it’s just so simple.

“But we don’t usually make simple, practical decisions, unfortunately. So that was my take the whole way through.”

First thing’s first - a call on the rule will almost certainly have to wait until the end of the season.

One comment from AFL CEO Gillon McLachlan on AFL 360 last week was in reference to the clarification on high tackle adjudication, but could easily have been about the medical sub rule as well.

“What I accept is there are a set of rules and the coaches and players are there in part to try and drive a truck through them, to use them to their advantage,” he said.

“That is actually what happens in sport, that’s what they do.”

“This is one that’s been exploited and people are trying to take unfair advantage of it, and you’ve got to tighten and clarify and communicate with the players, the clubs and the supporters, that’s what’s happened here.”

A straight concussion sub it must be noted was also part of the initial scope of the rule, before it was changed late in the piece to be a flat medical sub.

Should the AFL decide to modify the rule at year’s end, that is an avenue worth exploring.

Another scenario could see either a five-man bench or a situation where, once Team A has made its sub due to injury, Team B is able to activate its own sub for any reason.

There are no shortage of issues for the AFL to address, with a new broadcast deal and a verdict on Tasmania’s AFL prospects two of many.

When the AFL brain trust sit down at the end of the year to review what’s happening on the field, however, the medical sub rule is highly likely to come under the microscope.

Prior to Miller, 27 players this season of a possible 183 had been subbed out and gone on to play the next week.

There are many instances within those 27 that are genuine - Jeremy Cameron being admitted to hospital after one game is one such example - but there are also some that have raised eyebrows for footy fans.

If you go by the players and coaches’ majority view, some form of change is needed.

After all, there’s no substitute for common sense.