Mr. Humphrey was a relatively healthy guy, but he always knew that he had a family history that put him at risk of developing pancreatitis. So when he developed persistent symptoms—abdominal pain, fever, and nausea, he finally visited his doctor. She diagnosed him with pancreatic inflammation and immediately referred him to the University of Alabama-Birmingham’s (UAB) Pancreatobiliary Disease Center.
There, he was seen not by a single specialist, but by a multidisciplinary team that included pathologists, surgical and radiation oncologists, and others—including me, an interventional radiologist. Mr. Humphrey was particularly fortunate to be able to receive advice, counsel and a treatment plan that benefited from a broad range of medical perspectives, providing him the highest quality of care and peace of mind. If we could offer care like this to all our patients, imagine what we could do for them.
Benefits of a multidisciplinary specialist team
Every patient is unique and often care cannot and should not depend on the individual skills of any single specialist. While many medical specialists have the expertise to treat these conditions, if a practitioner works alone, he or she is often working within a narrow professional silo.
That could blind them to holes in treatment, means of treating unaddressed symptoms, and alternative approaches that can actually be life-saving or life-restoring. Pancreatobiliary conditions are particularly complex and notoriously difficult to treat. They may seem innocuous at first, but without optimal management, they can be fatal.
The Pancreatobiliary Disease Center
Until 2018, our facility had a patchwork of working relationships among multiple specialties. However, we knew there was room for meaningful improvement. That’s why we established our multidisciplinary model for collaborative, patient-centered care.
Our model brings together 13 specialty providers who meet every Wednesday morning. Instead of a haphazard system based on quick “hallway consults” among physicians, our team benefits from formal scheduled presentations of approximately a dozen cases each week. This enables us to have a healthy, holistic discussion of each patient’s needs. It also allows us to better coordinate each patient’s ongoing care.
In Mr. Humphrey’s case, this allowed specialists from surgery, interventional radiology, diagnostic radiology, and endoscopy to review his images and clinical history in detail. We were able to place his clinical course within our multi-disciplinary, algorithmic approach to pancreatitis and then tailor it to his specific needs.
Interventional radiology was able to provide an image-guided drainage of his infection. After hospital discharge, he was seen in the surgery clinic with notes about output and clinical symptoms sent to the interventional radiology clinic. This allowed for easy coordination of care when manipulation of the drain was required.
Managing as a multidisciplinary specialist team
Ultimately, as a team, we were able to manage this difficult illness in a relatively short period of time without invasive surgery.
Significantly, we have also developed cross-specialty protocols for various conditions, from cancers to cysts, to outline where every team member fits within the care plan. These established roles ensure we are all on the same page and the process itself builds trust and enhances the value of each specialty’s approach.
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Having support from our hospital leadership has been critical to our success. Their backing has helped to nurture the model into a large-scale effort. The goals are to:
- treat even more patients and
- improve patient outcomes and
- improve patient satisfaction.
But beyond these improvements, our team has been able to build capabilities and relationships among physicians to grow personally and professionally. We believe we are moving the field forward.
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Collaboration can scale
Our model is just one example of how collaboration on this scale can work wonders for patient care. But there are many medical facilities that have not had the motivation or capability to do so. I can speak from my personal experience that this goal can be accomplished with a few steps.
1. Acknowledge gaps
It starts with honestly acknowledging the gaps at your institution. Ask yourselves: What is missing in your procedures and outcomes that could benefit from this kind of collaboration? Where can specific improvements be made in patient care? And how do we do it?
2. Face-to-face communication
Hold open, face-to-face conversations with other specialists to begin forming partnerships, and most importantly, trust. Taking the time to meet with each other and show that you value others’ opinions will help to form a professional bond between providers. It also fosters a team mentality.
3. Get buy-in
Finally, when you’ve accomplished those goals, getting buy-in from top leadership and from the relevant players in key hospital services will build momentum for change. These relationships are key to making sure you have the resources and personnel to generate a meaningful transformation.
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The bottom line
Above all, you will be able to create a new mindset among your colleagues: Instead of asking “What can I do for this patient?” we now ask “What is really best for this patient?”
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Andrew J. Gunn, M.D.
Andrew J. Gunn, M.D. is the Assistant Program Director of the Diagnostic Radiology Residency Program at The University of Alabama. He is an expert in the field of interventional radiology with a special focus on treating cancer through minimally invasive techniques. He also is an expert in the treatment of uterine fibroids and IVC filter retrievals. He has written and lectured regarding patient-centered care in radiology and has interests in the clinical aspects of interventional radiology in addition to patient safety and quality of care. Currently, he is spearheading the division’s efforts to establish an outpatient interventional radiology clinic. He serves as a reviewer for multiple journals and as a section editor for a national database of teaching files tailored to radiology trainees.
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