Is the value of multidisciplinary meeting overstated? What happens when a clinician in charge of the care of a patient is overruled by a MDT group on thin grounds in a 50-50 situation. How do we quality assure an MDT meeting?
This is a complex issue.
The origins of Multidisciplinary team (MDT) meetings can be traced back to the time when our understanding of disease processes improved with the realisation and necessity of multi-modal treatments. In Oncological practices this allowed clinicians from varying streams to come together and plan the best treatment for a patient, based on the current & best available evidence. By and large it has worked well and has made treatment planning for patients more cohesive.
This was then adopted by other clinical groups and is a welcome development.
The MDT becomes a hindrance for an individual who does not fit the general bill, who often does not get a fair hearing. In such situations the patient & their clinician's voice often gets drowned. and one could say the MDT fails both.
Quality assurance is an important aspect of any service. At present we discuss a services' or a surgeons' outcomes but never of a MDT. We need to explore this further. Should we publish a MDT's 1 & 5 year patient survival & disease free survival?
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Kettunen, J., Penttilä, T. & Kairisto-Mertanen, L. (2013). Innovation pedagogy and desired learning outcomes in higher education, On the Horizon, 21(4), 333-342.
Teaching the skills needed for clinical leadership are crucial for Interdisciplinary Professional Education. Specific and contexualised training that includes the transfer of evidence based knowledge and best practice recommendations allows a confident clinical leader to transform the team. Even when the MD wants to dominate the medical model.
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