Team dynamics and clinician's experience influence decision-making during Upper-GI multidisciplinary team meetings: A...

Area of Science:

• Oncology
• Healthcare Management
• Qualitative Research

Background:

• Significant variation exists in curative treatment rates for esophagogastric cancer across hospitals.
• Factors driving these variations in clinical decision-making (CDM) during multidisciplinary team meetings (MDTMs) are not well understood.

Purpose of the Study:

• To explore clinicians' perspectives on facilitators and barriers to CDM during MDTMs.
• To identify factors within MDTMs that may explain inter-hospital practice differences.

Main Methods:

• A qualitative multiple case study design.
• Thematic content analysis of 16 MDTM observations, 30 clinician interviews, and 7 clinician focus groups.
• Verbatim transcription and coding of all interview data.

Main Results:

• Clinician characteristics (ambition, innovation) and treatment convictions/experiences influenced CDM.
• Team dynamics within MDTMs played a crucial role in decision-making.
• A spectrum of practice was observed, from conservative guideline adherence to more invasive, curative-intent approaches.

Conclusions:

• Variations in team dynamics are a key factor influencing clinical decision-making during MDTMs.
• Awareness of these dynamics can potentially help standardize treatment approaches and improve patient outcomes.