The idea of multidisciplinary team approach in the medical fields is not new but is gaining traction in the orthopedic world. Orthopedic geriatricians were early to adopt this approach to manage fractures in the older population and found that the functional outcomes were much better.1,2 This term, multidisciplinary, describes a collaborative work of various health professionals who work together to evaluate and treat an individual patient. They draw on their individual knowledge from their specialty to establish a common goal. This multidisciplinary team can look different depending on the setting, but the team can potentially consist of any, or all of the following:
- 1. Physician
- 2. Nurse Practitioner
- 3. Physician’s Assistant
- 4. Registered Nurse
- 5. Clinical Nurse
- 6. Surgical team
- 7. Anesthesiologist
- 8. Trauma coordinator
- 9. Case Manager
- 10. Physical therapist
- 11. Occupational Therapist
- 12. Athletic Trainer
- 13. Dietician/Nutritionist
- 14. Others
This team can provide a holistic, streamline approach during the care and recovery of an individual as everyone’s goals, expectations, support systems, work environments, home environment, priorities and values can look very different. If patients are seeing multiple health care providers who are working independently then the outcomes/goals may not be what is in the best interest of the patient because they are just seeing one aspect of the patient’s needs. However, if all the health care professionals are working collaboratively, the team compliments each profession and works to deliver a higher quality service and provides care for a diverse patient population. Research demonstrates the following benefits of multidisciplinary approach in orthopedics:
- 1. Improved patient outcomes
- 2. Higher patient and team satisfaction
- 3. Streamlined workflow and communication between healthcare providers
- 4. Reduced costs and length of stay
- 5. Fewer adverse events
- 6. More efficient use of resources and time
- 7. Increased access to a full range of therapeutic options
- 8. Optimize care
- 9. Minimize morbidity and reduce mortality
This team approach is not a new concept to the Shelbourne Knee Center as we have been utilizing this model for the past 10 years. The multidisciplinary team for every patient will consist of the patient, the physician, a nurse/physician assistant, a physical therapist/athletic trainer, x-ray specialist, and if surgery is required, the surgical team. Every one of these healthcare professionals are constantly working together to evaluate, re-evaluate and establish the best plan of care for each individual’s best interest considering their knee, support system, short- and long-term goals, living conditions, and other medical problems. When the patient first arrives in our clinic, they are initially seen by a physical therapist or athletic trainer who gets a history, gets x-rays, presents the case to the physician and reviews the x-rays and any previous medical records and diagnostic tests performed elsewhere. The therapist is in the room with the physician during the evaluation and examination of the patient so there is no confusion as to what the diagnosis or the plan of treatment the physician recommends.
Every therapist remains with the patient throughout the rehab, surgery (if indicated), and post op recovery until goals are met and patient is returning to prior level of function. At any time during this process, the therapist becomes the liaison between the patient and the physician. For example, if the original plan is to avoid surgery but the conservative treatment of therapy and medications are not helping, then the therapist can discuss with the physician the patient’s progress and determine the next step of surgery or other options. If surgery becomes the next step, then the nurse and physician’s assistant, along with the surgical team, becomes involved to ensure that overall medical history, medical clearances and care moving forward is completed to ensure for optimal recovery and excellent outcomes.
Patients who are included as part of the multidisciplinary team are more committed to the whole process and are more likely to comply with the treatment plan, which will lead to better outcomes. Education and communication are a huge part of this process as literature shows that patients who are fully educated during and throughout their treatment protocol are more likely to have better outcomes. The therapists, nurse, physician assistant, and physicians are available to the patients by phone and email for any questions and concerns throughout the recovery, as well as keeping the physician informed of the patient’s progress. A 2022 cross-sectional study of physician-patient communication found that patients’ compliance to treatment increased when the patient was satisfied with the overall communication and education.
The multidisciplinary team approach is the best way to treat patients allowing for increased options of treatment and increased compliance across multiple areas of the treatment plan which results in improved patient satisfaction, quality of care, and improved outcomes.