Integrated Multidisciplinary Vascular Care Models: International Perspectives and Indonesia's Experience

The increasing global burden of vascular disease and multimorbidity has highlighted the limitations of single-specialty care, necessitating a shift toward integrated multidisciplinary models. This narrative review synthesizes international guidelines and evidence to frame multidisciplinary vascular care as a formal governance model rather than an ad hoc clinical collaboration. By institutionalizing decision-making through structured boards, standardized pathways, and shared accountability, multidisciplinary teams (MDTs) effectively decouple treatment selection from procedural execution. This separation functions as a governance safeguard, reducing operator-driven bias and ensuring that care remains aligned with long-term, patient-centered goals. The review emphasizes that effective MDT function is enabled by shared competency, which allows diverse specialists to maintain consistent standards across diagnostics, medical therapy, and longitudinal follow-up. Evidence across arterial and venous domains demonstrates that structured MDT frameworks are consistently associated with improved clinical outcomes, including enhanced limb salvage and reduced mortality. Furthermore, the manuscript proposes extending these governance principles "upstream" to prevention-oriented services, such as venous outpatient clinics, to identify cardiovascular risk earlier in the disease trajectory. This governance-based approach is particularly relevant for middle-income health systems, such as Indonesia, providing a scalable framework to standardize care and improve access to appropriate interventions.