Multidisciplinary team meetings can be a great help. If you are undergoing a major treatment or surgery, ask if your case will be discussed by MDT teams. The benefits are obvious, your medical situation can be discussed by a team of specialists and/or healthcare practitioners. Ideally you should be present at the meetings. You should have a right to know who has input into decisions affecting your healthcare, and also the rationale behind decisions
One would also expect that patients could access a record of who attends meetings and a summary of the basis on which decisions are made.
Like most things in healthcare, practice does not work as well as theory. I doubt there are any politicians or doctors who could really understand just what it is like to be a faceless public hospital patient who must rely on a secretive mysterious unknown “team” to make life and death decisions for them.
Having had the unfortunate experience of watching a family member endure an extended stay due to surgical complications , in a QLDHealth public hospital, I came to view “the team” as a big excuse for no one seeing their role as providing information, and no one accepting any responsibility.
A decision is always made by “we” , “they” or “the team” . Even the Consultant refers to the team as “they”. Doctors always seem to covey the message that no explanation or rationale is necessary as “the team is infallible”. The patient is requested to have blind trust. If one asks for an explanation, one is seen as unreasonable because “the team has decided”. A patient does not get much respect, they are not kept informed or given a rationale for decisions. They are not told who attends team meetings and who makes decisions.
If you ask a question about a team decision, junior doctors advise you to ask senior doctors. Seniors doctors are no where to be seen, or too busy to provide an explanation except to say the team knows best.
If you try to ask questions , you are told the team wants, or the teams thinks . You are not told who the team is, or why the team thinks or why the team wants as they do. If you want more information about the team, you might try to ask questions.
“Who is on the team ?”
“Well — er — we all are”
“Ok, then who made this decision ? ”
“I don’t know, they have team meetings ”
“Did you go to the meeting ?”
“No”
“Do you know who went to the meeting ?”
You never get an answer to that one.
If you persist, you might get a list of doctors who are on the team, but this does not mean anything. Just because a doctor is on the hospital’s Multidisciplinary team , it does not mean that they attended the particular meeting which discussed your condition. It does not mean that they know you exist.
After much enquiry, you might find out that Dr John Smith is on the team, but you will never know if Dr John Smith attended the meeting. He may have attended. He may have sent a senior registrar. He may have sent his most junior intern. He may have sent no one. He may have thought your condition was not worth a minute of his time.
You may find out that there are a number of oncologists on the team, but none of them may have sent a representative to the team meeting. I got the impression that many public hospital cancer patients never see anyone from the oncology team. My family member never saw anyone from the oncology team for about 10 months after the surgical team diagnosed his cancer. Public hospitals wander why patients and families often loose confidence in the care provided. When things are continuously going wrong and the patient suffers more and more complications, doctors talk less and less and few people could have blind faith in the public health system.
Did an oncologist ever attend a team meeting ? I will never know. No one was able or willing to answer this question. While we were told that there were regular MDT meetings, there is very very scant reference to them in the medical records and never any mention of who attended these meetings.
If there is such a thing as a record of MDT meetings, this should be made available to patients, they should have a right to be informed. Accurate records should be kept of MDT meetings. These meetings should be open and accountable, not secretive.
Do MDT meetings really serve the patient or are they just there to serve the health service ? I don’t know. I can’t know because there is no information for patients and families.
The Health Minister and The Department of Health are failing to ensure that QLDHealth hospitals function in an open and transparent manner. They fail to provide patient’s rights to be informed and engaged in their health care decisions as set out by The Charter of Patient Rights.
