Seeing the Whole Patient: An Interdisciplinary Approach for Optimal Patient Care
Published on 28 January 2018
Too often, health care practitioners get only a snapshot of their patients’ conditions and find themselves working in silos. Through an interdisciplinary approach, providers can share knowledge, form a more complete picture of a patient and achieve better outcomes.
The value of interdisciplinary teams is well documented and accepted, but the implementation of this approach is not without obstacles. Professional boundaries, communication barriers and patient cases rife with multiple diagnoses make the process of moving toward interdisciplinary care more complex than it appears.
Melanie VanDyke, Ph.D., assistant professor of psychology at St. Louis College of Pharmacy and licensed psychologist, is always eager to share the opportunities for psychologists, pharmacists and other health care professionals to collaborate on patient care. VanDyke sits on the Public Education Committee for the Anxiety and Depression Association of America. Part of her role is developing educational tools to address common questions. After the success of a webinar she organized addressing patient medication questions and opportunities for pharmacists to provide support, VanDyke proposed a roundtable discussion to bring even more providers into the conversation. She, along with Amy Drew, Pharm.D., BCPS, associate professor of pharmacy practice at the College, coordinated and led a collaborative case exercise at the Anxiety and Depression Conference held in San Francisco.
VanDyke chose the case of a patient suffering from obsessive-compulsive disorder, panic disorder, irritable bowel syndrome and diabetes. VanDyke recruited health care professionals from a wide spectrum of disciplines, including pharmacy, psychiatry, psychology and social work, to each provide their perspective on treatment. Drew represented the role of the pharmacist.
“We cannot practice in a vacuum,” Drew explained. “We need to work with different disciplines and understand what our goals are to facilitate effective treatment. My goal, as a pharmacist, is to be involved in both the decision-making about which medications are prescribed and also the patient education part.”
The roundtable provided a platform for the representative of each profession to make observations on the case and contribute to the treatment plan. The exercise highlighted the intersections between scopes of practice and the value of each team member.
“Research supports that you are providing more optimal care when you are collaborating and talking to other professionals,” VanDyke said. “Even on an individual patient level, if you are supporting the treatment of another provider, it provides additional credibility to each aspect of the treatment.”
Despite the success of the collaboration, there were several barriers the team encountered during the exercise – namely, communication and availability.
Representatives of each profession had differing preferences on how to communicate. To accommodate these preferences, the team focused on provider-relevant information, sometimes taking the form of a conceptual narrative or a brief breakdown of medication-related information. Preferred methods of sharing information also vary. Phone conversations may be better for the psychiatrist, while the pharmacist may prefer medical records over a secure system. The team found these obstacles were difficult to overcome but not impossible.
“We all see the value in communication, and we all see how it can improve patient care, which is ultimately what we are all trying to do,” Drew said. “Different disciplines and different settings might work within the same network, but in the case of a private clinic or different health system, communication gets more complicated.”
Accessing the whole picture of a patient may not always be easy for health care professionals. With patience, openness and a commitment to providing optimal care, an interdisciplinary team can bring blurry images into focus.
“We have overlapping roles, but we all have our specific scope of practice in which we can provide expertise,” VanDyke added. “The relationship between disciplines is critical to support an effective therapy.”
This story was first published in the fall 2017 issue of Script. Visit stlcop.edu/script to read more and access previous issues.