Jose Mourinho's treatment of Chelsea doctor Eva Carneiro is another truculent assertion of his power

The message, in the case of Eva Carneiro, seems to be that if you cross Jose Mourinho at Chelsea then, as ever, there can be just one outcome: you are marginalised and, in the long term, out the door. Length of service or reputation does not matter one bit.

The club are well aware that the fallout from the Carneiro case will not portray them in a good light. With all her major duties removed – on-field care during matches, even a presence on the training field at Cobham – it means that Carneiro, the club’s first-team doctor, is expected to leave sooner rather than later.

As a high-profile woman who has taken sexist abuse from opposition fans wherever she has worked – and some pretty unspeakable levels of it at certain times – Carneiro had become a pioneer in her field for women in sports medicine. She gave a rousing address at a seminar in Sweden last year encouraging young girls to follow in her footsteps, recalling her 16-year-old self watching football on television and wanting to be “that guy [doctor] who runs on to the field”.

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The club are adamant that there is no sexist element to the decision: Mourinho’s criticism on Saturday was of both Carneiro and Jon Fearn, the club’s head physiotherapist whom he judged too quick to rush on to treat Eden Hazard. What the Chelsea manager does seem guilty of is a massive overreaction. There had been no previous cracks in his working relationship with Carneiro. It was only on Friday that Mourinho described his faith in the medical team as “complete” when discussing Diego Costa’s injury.

What has changed since then is the innocuous Facebook post from Carneiro on Sunday night in which she thanked people for their support. In the context of life at Chelsea that looked provocative, given how much the club discourages backroom staff from make any public pronouncements. It appeared that these nondescript few words of gratitude had sealed Carneiro’s fate and her time at Chelsea was as good as up.

Mourinho has been here before. In 2005, the then club doctor Neil Frazer left Chelsea after he and Mourinho, in his first spell at the club, disagreed over an issue concerning Arjen Robben’s fitness. Like all managers, Mourinho likes his players to be fit and available and, as with many clubs, that can lead to differences of opinion.

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The relationship between a doctor and a manager is complex. The former has his or her duty of care to the players while also having to satisfy the demands of their boss to speed up recovery from injuries. In May 2006 the Manchester United doctor Mike Stone left the club suddenly just days before Wayne Rooney had a crucial scan on his broken metatarsal ahead of the World Cup that summer.

The problem in Carneiro’s case is that it was very much Mourinho who made Saturday’s incident into an issue that attracted the media’s attention – from his furious reaction on the touchline when Fearn and Carneiro rushed on to his criticism of them after the game. And his decision to remove all Carneiro’s major duties will only make matters worse.

That move was so unexpected to many staff that they had no idea who would take over from her at the Etihad Stadium on Sunday. The Academy doctor Julian Redhead may have to step up.

In her address in Sweden last year, Carneiro recalled her days working in emergency rooms when it was a matter of “life and death”. It says something about the environment she works in at Chelsea that she identified that previous experience as having “really helped me deal with the pressures of where I work now”. She said that the key factor in being successful at Chelsea was “communication at all levels” – which has a particular resonance now.

As a pathfinder in her field, and one who broke down one of the major male bastions in the game, it seems a dreadful waste that Carneiro’s promising career at Chelsea has gone up in smoke over such a piffling incident. She has never courted publicity and her speech in Sweden, available to view online, is a well-judged, often inspiring analysis of the careers of women in medicine.

The reasons for her demotion lie squarely at the feet of Mourinho, who will have his rationale for a decision that he knows will make life very difficult for his club over the next few days. Whether any of it makes sense, beyond a truculent assertion of his power at the club, remains to be seen.

Saturday, 7.13pm Chelsea midfielder Eden Hazard is brought down by Swansea counterpart Gylfi Sigurdsson towards the end of the 2-2 draw at Stamford Bridge.

7.14pm Club physiotherapist Jon Fearn and doctor Eva Carneiro enter the pitch to attend to Hazard, to the visible annoyance of manager Jose Mourinho. The Belgian is forced to leave the pitch briefly after being treated, leaving Chelsea, already down to 10 men, at a disadvantage.

7.50pm Mourinho criticises the pair in a post-match interview. “I was unhappy with my medical staff,” the Portuguese said. “They were impulsive and naive. Whether you are a kit man, doctor or secretary on the bench you have to understand the game.”

Sunday, 8.40pm On Facebook Carneiro thanks fans for backing her: “I would like to thank the general public for their overwhelming support. Really very much appreciated.”

Tuesday, 4pm Carneiro has duties at the club downgraded, including her removal from the bench on match day. She will now only work from Cobham training base.

For such a combustible character, it is not surprising that Jose Mourinho has a history of falling out with colleagues at the various clubs he has managed. But the Portuguese usually only locks horns with those he believes to be a threat to his position.

His first spell at Chelsea came to an abrupt end in 2007 partly due to growing problems Mourinho had with sporting director Frank Arnesen and his close ally Piet de Visser, who is a confidant of owner Roman Abramovich.

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Mourinho reportedly tried to ban Arnesen from the training ground when he was first appointed in 2005 but the final straw in his relationship with the club was the arrival of Avram Grant as director of football in June 2007 – the ‘Special One’ left three months later.

Similar problems dogged Mourinho’s first year at Real Madrid when he clashed repeatedly with sporting director Jorge Valdano. The Argentine was especially outspoken following the 5-0 thrashing by arch rivals Barcelona in November 2010, criticising Mourinho for remaining on the bench for most of his side’s humiliation at the Nou Camp.

Mourinho had the final word on that occasion when victory over Barça in the Copa del Rey in April 2011 strengthened his hand sufficiently for Valdano to be sacked by Real president Florentino Perez. He did not go quietly, though. Valdano later said their problems arose as follows: “I couldn’t understand him because he is the antithesis of my sensitivity. Intelligence and ego are enemies and when they collide, the ego wins.”

Back at Chelsea, all has gone swimmingly until this summer. Before the bust-up with Eva Carneiro, Mourinho also criticised goalkeeping coach Christophe Lollichon for speaking out of turn about Paris Saint-Germain. With rumours circulating that the manager is unhappy with Lollichon’s training sessions, perhaps he, like Carneiro, will soon be out in the cold.