Should patients be included in multidisciplinary team meetings?
Involving patients in decision-making process is especially important for managing back pain—so what can be done to improve that process? The authors of a new analysis published in Clinical Radiology believe all parties—the radiologist, the referring clinician, any other relevant physicians, and the patient—should be brought together to help achieve the best patient care possible.
Traditionally, the authors explained, the involved parties are “separated in time and space,” leading to less-than-ideal care management.
“After the scan is reported, it falls to the clinician to integrate the imaging findings with the clinical presentation, as best can be ascertained from memory and the documentation in the notes,” wrote Andrew Nanapragasam, from the Department of Radiology at Newcastle University in the U.K., and colleagues. “The radiologist is not present at this time and any questionable imaging findings that require ‘clinical correlation’ cannot be discussed with the reporter. Even when clinicians and radiologists meet in a multidisciplinary team meeting, there is still uncertainty about the significance of all the intercurrent degenerative changes that may or may not be causing symptoms.”
Nanapragasam and colleagues proposed a new approach, which they have called a Patient Incorporated Multidisciplinary Team (PI-MDT). In a PI-MDT, everyone is brought to one place, allowing the patient’s background to be fully explained. In addition, this helps all parties make correlations between the patient’s history and imaging findings.
Such an approach benefits the radiologists, the authors added, because they receive feedback in real-time and they get to see the impact they make on patient care.
Also, Nanapragasam and colleagues added, there are numerous benefits for the patients themselves.
“From the patients' perspective, their attendance at the meeting allows them to better understand the nature of their condition and how treatment decisions are made,” they wrote. “Furthermore, the visual presentation of pathology can help bring home the relative severity of their condition, therefore making them more likely to engage with the proposed treatment. This is especially important with back pain as rehabilitation, exercise, and lifestyle changes form key parts of the management.”
There are potential “pitfalls” related to involving the patient in these meetings, the authors noted. The meeting may take longer than it would otherwise, for example, or lay language may have to be used throughout the discussion. And there may even be clinicians who are not comfortable discussing certain topics in front of the patients.
Overall, though, the team thinks its approach can provide real, positive change for patients.
“Our PI-MDT model puts the patient experience at the heart of the discussion around their treatment and would allow clinical correlation to be obtained in real-time,” the authors concluded. “We believe that the proposed model has benefits for patients, clinicians, and radiologists, and suggest that formal evaluation be undertaken.”
Michael has more than 18 years of experience as a professional writer and editor. He has written at length about cardiology, radiology, artificial intelligence and other key healthcare topics.