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Function of the Team

Chapter 22 - The Role of the Multidisciplinary Team

Organisation of the team at the H. Lee Moffitt Cancer Center and Research Institute in Tampa.

The organisation of the team is not codified. In our institution, the H. Lee Moffitt Cancer Center, a geriatric team has been operating for 21 years. Though it has undergone some evolution, the basic organisation has remained the same (Fig. to the right). All cancer patients aged 70 years and older are screened by a nurse for age-related problems. Patients who screen positive undergo a consultation by the whole team that reports the findings to the physician who is responsible for the initial treatment plans.

All patients are discussed at the weekly multidisciplinary conference attended by the full team that issues final recommendations and a letter to the patient and the referring physician. During this informal discussion, new consultations are generated that might have been originally overlooked and all team members become aware of their own specific role in the management of the individual patient.

Of course, the functioning of the team is predicated on its cohesiveness and mutual trust of its members. Team building and team maintenance involve friendship, confidence, and open communication that are promoted by the team leader. This is not necessarily a physician; rather, the team member who is the most experienced in team building. The nurse practitioner and social worker have, at times, assumed such a role at our centre.

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