Transcript INTERDISCIPLINARY TEAM ISSUES

Prof. DR. E. Sutedja dr SpKK(K)
WHAT IS INTERDICIPLINE
TEAM
WHAT IS INTERDICIPLINE
TEAM
COLLABORATION AMONG :
GP AND A SPESIALIST
GPs
DIFFERENT SPECIALIS
OTHER HEALTH PROFESIONAL
(NURSE, PHARMACIST, NUTRITIONIST)
WHY WE NEED
INTERDICIPLINE TEAM
IN TEACHING HOSPITAL
IN TEACHING HOSPITAL

TEAM MEMBERSHIP BECOMES THAT
MUCH MORE COMPLEX WITH THE
PRESENCE OF STUDENTS,
RESIDENTS, AND FELLOWS.
HOW DO TEAMS WORK
TOGETHER?
HOW DO TEAMS WORK
TOGETHER?
MAJORITY OPINION,
 DEFERENCE TO MORE
EXPERT OPINION,
 UNANIMITY, OR
CONSENSUS

AUTOCRATIC
CHOICE
WHO IS IN CHARGE IN THE OPERATING ROOM?
ISN'T THE SURGEON "CAPTAIN OF THE SHIP"?
WHO IS IN CHARGE IN THE OPERATING ROOM?
ISN'T THE SURGEON "CAPTAIN OF THE SHIP"?
IN 1949  PENNSYLVANIA SUPREME COURT
MCCONNELL VS. WILLIAMS
IN RECENT YEARS, MANY STATE SUPREME
COURTS HAVE SPECIFICALLY THROWN OUT THE
"CAPTAIN OF THE SHIP" DOCTRINE IN DISGUST
THE SURGEON WAS RESPONSIBLE FOR THE ACTS
OF NURSES, NURSE ANESTHETISTS,
ANESTHESIOLOGISTS, RADIOLOGISTS, AND
RADIOLOGY
PHYSICIAN-NURSE COLABORATION
Physician and nurse  gradually envolving
into a collaborative model
 Physician assumed the lead role in many
collaborative research initiative
 Non-hierarchical in nature
 Work well, shared interest and open lines of
communication
 Mutual respect, trust, shared interest and
commitment

“We Must all hang together or, assuredly, we shall all
hang separately”
WHAT ARE THE ETHICAL OBLIGATIONS OF
MEMBERS OF THE INTERDISCIPLINARY TEAM
IN PATIENT CARE?
WHAT ARE THE ETHICAL OBLIGATIONS OF
MEMBERS OF THE INTERDISCIPLINARY TEAM
IN PATIENT CARE?

EVERY
MEMBER
HAS
SEPARATE
OBLIGATIONS, WHICH ARE BASED ON THE
PROVIDER'S
PROFESSION,
SCOPE
OF
PRACTICE AND INDIVIDUAL SKILLS.

ALSO HAVE ETHICAL OBLIGATIONS TO TREAT
EACH OTHER IN A RESPECTFUL AND
PROFESSIONAL MANNER.

NEED TO WORK TOGETHER IN ORDER TO
BEST UTILIZE THE EXPERTISE AND INSIGHTS
OF EACH MEMBER.
DO I HAVE TO DO WHATEVER I AM TOLD BY
THE ATTENDING PHYSICIAN, EVEN IF I
DISAGREE WITH THEIR PLANS?
DO I HAVE TO DO WHATEVER I AM TOLD BY
THE ATTENDING PHYSICIAN, EVEN IF I
DISAGREE WITH THEIR PLANS?
SHOULD SEEK INPUT FROM THE
ATTENDING
 BOTH ABOUT THE REASONING TO PURSUE
THE ATTENDING'S PLAN
 THE REASONING FOR REJECTING HER
OWN

A RESPECTFUL EXCHANGE OF VIEWS MAY
PROVIDE BOTH PARTIES WITH NEW INFORMATION,
AND CERTAINLY SERVES TO FURTHER
EDUCATION.
WHAT IS MEANT BY "RESPECTFUL"
EXCHANGE OF VIEWS?
WHAT IS MEANT BY "RESPECTFUL"
EXCHANGE OF VIEWS?

BOTH LISTENING TO AND
CONSIDERING THE INPUT OF OTHER
PROFESSIONALS

RESPECT  LANGUAGE, GESTURES,
AND ACTIONS
"I acknowledge and respect your perspective in this
matter, but for the following reasons. I disagree with
your conclusions, and believe I should do something
else..."
HOW CAN DISAGREEMENTS ON THE
MULTIDISCIPLINARY TEAM BE HANDLED?
HOW CAN DISAGREEMENTS ON THE
MULTIDISCIPLINARY TEAM BE HANDLED?

INTERPROFESSIONAL DISCUSSION

RESULTING IN A NEW CONSENSUS

CONSULT OTHER PROFESSIONALS

ETHICS COMMITTEE
FOUR PRINSIP THE PHYSCIAN
ETHICS :

BENEFICENCE

NON MALEFICENCE

AUTONOMY

JUSTICE
THANK YOU