Interdisciplinary Relationships

A biomedical model of the disease, which was introduced by Louis Pasteur, had dominated Western medicine for more than a century. According to it, the disease occurs due to some biological defect. As a result, for many years, the symptoms that could not be explained by the use of biological notions had simply remained out of the discussion. Nevertheless, the biomedical model of the disease was rather successful as at the beginning of the XX century, the primary causes of death were tuberculosis, pneumonia, flu, and diarrhea. However, by the end of the century, the situation began to change. In particular, people have started succumbing to chronic illnesses such as heart disease, cancer, and stroke. In turn, these changes required a thorough study of the symptoms and causes of the disease, which often could not be performed by a single healthcare specialist. Therefore, a completely new biopsychosocial model was introduced by George Engel, an American psychiatrist. It has eventually changed not only the minds of professionals working in the field of medicine but also the very healthcare system (namely in the United States). In particular, it has promoted a patient-centered approach, which is provided by a multidisciplinary team of specialists. However, the reliance on the teamwork, especially when the team members are proficient in different disciplines may not only improve the quality of healthcare services but also become a source of conflicts within the healthcare facility. Therefore, the following essay studies the most common cases of interdisciplinary relationships in the healthcare. In addition, it offers the methods of resolving these conflicts at the team level and defines the benefits of the interdisciplinary approach implementation.

In the healthcare industry, the multidisciplinary relationship and collaboration can be manifested in many forms. However, the most obvious one, which is present in almost every branch of healthcare, is medical imaging, namely radiology, which lies at the intersection of general medicine and most medical and surgical specialties. The primary interdisciplinary clinical applications of radiology include:

  • Collaboration with the oncology and traumatology (bone scan) in order to evaluate the metabolic activity of a bone. It is widely used for determining the stage of cancer or arthritis, or the severity of a fracture;
  • Collaboration with the cardiology (myocardial perfusion scan) for the comparison of the blood flow to myocardium during physical exertion and at rest; it allows to differentiate between ischemia and infarction;
  • Collaboration with nephrology (scan of the kidneys) to determine the renal perfusion and drainage;
  • Collaboration with endocrinology (thyroid scan) to evaluate the appearance and function of the thyroid gland.

However, the interdisciplinary relationships are not limited to the collaboration of only two disciplines. Very often, the diagnostics and the development of a treatment plan require combined efforts of many healthcare specialists. The most vivid example of such a relationship is the process of diagnostics and treatment of a patient suffering from cancer. In particular, in the case there is a possibility of cancer metastases to certain organs and tissues, oncologists collaborate with surgeons when analyzing the radiographs of a patient. By working together and joining their knowledge, they can define whether it is possible to remove the carcinoma surgically or not. These specialists are also consulted by radiologists that can provide additional information on some details of the radiograph. Therefore, the plan of surgery is simultaneously developed by three healthcare specialists with the possible involvement of the other physicians, depending on the affected part of the patient’s body. After the surgery, the oncologist may assign chemotherapy in order to reduce the likelihood of the further spread of metastases.

 

Therefore, it is possible to say that there is no solo work in the modern medicine. Nowadays, the interdisciplinary approach involves all the major clinical disciplines of the healthcare, such as cardiology, gastroenterology, and endocrinology. There are no more areas of the isolated use of the laws and methods of pathological anatomy and physiology, medicine and surgery, dentistry and radiology; there is only a scope of their mutual collaboration. However, since the modern healthcare heavily relies on the cooperation between different disciplines, it also becomes prone to conflicts at the team level. This problem may have serious consequences for both the patient and healthcare facility, as a whole.

Resolving and preventing these inner conflicts creates not only educational, moral, and ethical but also economic problems. In particular, the loss of working time due to conflict, as well as the post-conflict experiences, accounts for about 15% of the total working time. At the same time, the decrease in the labor productivity ranges from 2.2% to 16% in the post-conflict period. However, it should be noted that the provided figures are true for the work that takes place in favorable conditions. Therefore, for healthcare workers, they will be even higher. The provision of the healthcare services is an extremely complicated work that is accompanied by great physical and emotional stress. In addition, the patient often expects the doctor will know everything about his/her case, will never make a mistake, and, if necessary, work a miracle. In such conditions, a conflict situation may have severe consequences and result in an error during diagnostics or treatment with a patient’s life as a price for it. 

In the case of interdisciplinary relationships in healthcare, there are the following three types of conflict: 

  • Interpersonal conflict – a struggle for scarce resources, medical equipment, or approval. It may also be manifested as a clash of personalities;
  • Conflict between an individual and the group. It may occur in the case the goals of the group are in conflict with the expectations of an individual;
  • Intergroup conflict. The teams of healthcare specialists may come into conflict with each other due to the differences in their objectives.

It is clear that conflicts are highly undesirable in the healthcare facilities. Therefore, it is required to utilize the following structural methods of the conflict management:

  1. Clarification of the requirements for the job; namely, the results that are expected from each employee and team. Subordinates must understand what is expected of them in any given situation and act accordingly.
  2. Mechanisms of coordination and integration; namely, a chain of command. In the case two or more subordinates have a disagreement on some issue, the conflict can be avoided by referring to their common superior, leaving the decision to him or her.
  3. Organization-wide comprehensive goals. The efficient implementation of these goals requires joint efforts of two or more employees or teams. The primary idea of this method is directing the efforts of all the parties to the achievement of a common goal.
  4. The remuneration system. The bonuses can be used as a method of the conflict management, which is able to influencing people’s behavior. Employees that contribute to the achievement of the corporate objectives, promote teamwork, and try to approach the problem in a complex way should be rewarded with gratitude, remuneration in money, recognition, or promotion.

In the case the system of interdisciplinary relationships works smoothly, without any conflicts, it can bring various benefits both to the healthcare facility and its patients. In particular, the interdisciplinary approach promotes the patient-centered care. In general, a patient becomes an active participant in the medical interaction; he or she is a speaker rather than a listener. As a result, the patients, as well as their families, can receive a detailed consultation on the priorities of a particular treatment or healthcare program. Moreover, they may be granted access to the independent information on healthcare. In turn, such measures provide patients (families) with an opportunity to plan their individual care packages with the help of a team of healthcare specialists. A direct involvement in the planning process will result in the most complete satisfaction of a patient’s needs, as well as develop at him or her a sense of responsibility for own health and well-being. At the same time, it provides certain financial benefits to the patient and his or her family by making it possible to calculate precisely the cost of the treatment. Therefore, the person may add or remove certain healthcare services from the care package so it can meet his or her family’s financial capacity. Therefore, the need for a loan is eliminated.

In addition, the interdisciplinary relationships bring significant benefits to the healthcare facility, in which they are used. In particular, the spirit of cooperation dominating the clinic is a powerful stimulus for learning. During the collaboration, a process of the knowledge exchange usually takes place. As a result, the healthcare specialists gain knowledge and skills in the areas of medicine that are out of their expertise. Therefore, the professional level of the physicians rises over time, as it is one of the primary conditions of working in the system of interdisciplinary relationships. The professional development of the rest of the staff occurs in a similar way. In turn, it results in the higher quality of the services provided by the healthcare facility. Moreover, since the barriers between different medical disciplines tend to fade, the company does not require a large number of specialists. Consequently, its operational costs and, thus, the price of the healthcare serviced, will also be lowered. These two factors (price and quality) are the critical components of the competitiveness of any organization. Therefore, by implementing the interdisciplinary approach, the healthcare facility will be able to claim a larger market share by taking it from the competitors that cannot offer the same or better conditions. As a result, the revenues of the organization will increase.

As a conclusion, it is possible to say that collaboration and cooperation have become the primary principles of the modern healthcare industry. The emergence of new diseases, namely those of a chronic nature, requires a thorough analysis both of the symptoms and the flow of the illness. By taking into account the fact that many of them are not manifested until the latter stages of the disorder, for example, in the case of cancer, and require the use of specialized methods of diagnostics, it is clear that this work cannot be performed by a single physician. Therefore, individual employees of the healthcare facilities of various specialties become active team players, who target the needs of the patients. The primary reason for this initiative is the need for the expertise and skills of various specialists in the treatment of complex diseases. Despite the high risks of potential conflicts, the interdisciplinary approach has proven to be efficient by providing the benefits to the patients (high quality of healthcare services), healthcare specialists (the constant improvement of the professional level), and healthcare facilities (lowered costs and improved performance). Therefore, it is clear that this medical model is bound to dominate the global healthcare industry in the future.

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Oct 25, 2019 in Communications
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