How multidisciplinary are multidisciplinary team meetings in cancer care? An observational study in oncology departments in Flanders, Belgium

Abstract

Melissa Horlait,1 Saskia Baes,1 Sophie Dhaene,2 Simon Van Belle,3 Mark Leys1 1Vrije Universiteit Brussel (VUB), Department of Public Health, Research Group Organisation, Policy and Social Inequalities in Health Care (OPIH), 1090 Brussels, Belgium; 2AZ Sint-Elisabeth Ziekenhuis, Department of Oncology, 9620 Zottegem, Belgium; 3Ghent University Hospital, Department of Medical Oncology, 9000 Gent, Belgium Background: In current cancer care, multidisciplinary team meetings (MDTMs) aim at uniting care professionals from different disciplines to decide upon the best possible treatment plan for the patients based on the available scientific evidence. In Belgium, the multidisciplinary approach is mandatory and formally regulated since 2003. Current research indicates that MDTMs are not always truly multidisciplinary, ie, with a mix of medical as well as paramedical disciplines, and that the medical profession (physicians and medical specialists) tends to dominate the interaction in MDTMs. To ensure that MDTMs can benefit from their diverse membership to achieve their full potential, significant attention should be devoted to the multidisciplinary character of these meetings. The aim of this study is to explore and describe the multidisciplinary character in MDTMs and how it is actually shaped in practice in different Flemish medical oncology departments. Methods: For this study, we carried out an observational comparative case study. We studied 59 multidisciplinary team meetings at inpatient medical oncology departments in five different Belgian hospitals (academic as well as general) and explored multidisciplinarity and how it is actually shaped in practice.Results: The study is unique in identifying and analyzing three distinct types of MDTMs. The analysis of the three types revealed an inconsistent and, at times, contradictory picture of multidisciplinary team meetings. The findings also align with previous studies arguing that MDTMs in oncology are typically driven by doctors, with limited input of nurses and other nonmedical staff in which decisions are argued on biomedical information and far less consideration of psychosocial aspects.Conclusion: The concept of a MDTM should not merely be a group of care professionals who work essentially independently and occasionally liaise with one another. Yet, this study has shown a worryingly low awareness of the true character of multidisciplinarity, particularly among medical disciplines. Keywords: medical oncology, multidisciplinary teams, interprofessional care, qualitative research, health services research

Keywords

• medical oncology – multidisciplinary teams – interprofessional care – qualitative research – health services research