Models for the Delivery of Interdisciplinary Care

As noted previously, there is broad support on the part of both medical professional organizations and patient advocacy groups for an interdisciplinary approach to cancer care. It is generally accepted that care labeled as such is characterized by the participation of multiple specialists in the formulation of an individualized treatment plan for each patient. However, beyond this definition, the optimal structure for such a process has not been clearly defined.

Three models for the provision of interdisciplinary gastrointestinal cancer care have been described in a 2002 monograph prepared by The Advisory Board Company.118 The simplest model consists of a prospective treatment planning conference. Next, in order of increasing complexity, is the virtual clinic, in which a coordinator facilitates movement of the patient through his/her multiple physician visits and testing procedures. The highest level of integration is achieved by the establishment of a "comprehensive clinic," in which all physicians involved in the care of the patient practice in a single location (Table 14.2). There are no available data to indicate either the number of institutions that are providing interdisciplinary cancer care or the specific model(s) in use at these intuitions.

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