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From Silos to Synergy: Building Resilient Multidisciplinary Oncology Teams
Raymond Liu1,2,3, Lidia Schapira4, Sheetal Kircher5
1Department of Hematology Oncology, The Permanente Medical Group, San Francisco, CA.
Abstract:
Modern cancer care is highly complex and interdependent, requiring coordination across specialties, settings, and time points. When interdependence is not intentionally managed, care delivery becomes fragmented, resulting in delays, inefficiencies, and increased burden on clinicians and patients. High-functioning multidisciplinary teams are essential for delivering timely, patient-centered oncology care and sustaining the oncology workforce. However, practical approaches for establishing and operating these teams remain limited. This article presents a practical roadmap for establishing and sustaining high-functioning oncology teams using the 4R oncology model (right information, right care, right patient, right time). The model operationalizes teamwork by centering the team goals and actions around explicitly managing the timing and sequencing of interdependent care through a structured tool, the Care Sequence, which provides a patient-centered roadmap of guideline-concordant care across specialties. Implementation includes team formation, collaborative optimization of care processes, and integration of coordinated workflows into routine clinical practice, including continuous learning processes that support adaptation over time. We highlight the central roles of patients as active members of the care team with capacity for self-management, and of nonphysician professionals essential for reliable team-based care delivery. Because multidisciplinary collaboration generates differing perspectives, we discuss structured approaches to conflict resolution that transform disagreement into productive problem-solving and system improvement. Finally, as oncology practice becomes increasingly interconnected across institutions and countries, we consider how team-based structures support collaboration across diverse settings and geographies. Together, these principles offer an actionable framework for transforming siloed structures into coordinated, resilient oncology teams capable of delivering high-quality cancer care.
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