Background In current cancer care, multidisciplinary team meetings (MDTMs) aim at uniting care professionals from different disciplines to decide upon the best possible treatment plan for the patients based on the available scientific evidence. In Belgium, the multidisciplinary approach is mandatory and formally regulated since 2003. Current research indicates that MDTMs are not always truly multidisciplinary, ie, with a mix of medical as well as paramedical disciplines, and that the medical profession (physicians and medical specialists) tends to dominate the interaction in MDTMs. To ensure that MDTMs can benefit from their diverse membership to achieve their full potential, significant attention should be devoted to the multidisciplinary character of these meetings. The aim of this study is to explore and describe the multidisciplinary character in MDTMs and how it is actually shaped in practice in different Flemish medical oncology departments. Methods For this study, we carried out an observational comparative case study. We studied 59 multidisciplinary team meetings at inpatient medical oncology departments in five different Belgian hospitals (academic as well as general) and explored multidisciplinarity and how it is actually shaped in practice. Results The study is unique in identifying and analyzing three distinct types of MDTMs. The analysis of the three types revealed an inconsistent and, at times, contradictory picture of multidisciplinary team meetings. The findings also align with previous studies arguing that MDTMs in oncology are typically driven by doctors, with limited input of nurses and other nonmedical staff in which decisions are argued on biomedical information and far less consideration of psychosocial aspects. Conclusion The concept of a MDTM should not merely be a group of care professionals who work essentially independently and occasionally liaise with one another. Yet, this study has shown a worryingly low awareness of the true character of multidisciplinarity, particularly among medical disciplines.

Introduction Coordinating cancer care is challenging because of its complexity. To partly encounter this complexity, multidisciplinary team meetings (MDTMs) were implemented to evaluate diagnosis, discuss treatment options and collectively decide upon the most optimal patient care and treatment plan. In cancer trajectories, medical professionals have a coordinating role and final decision responsibility. As a consequence patient-centred non-biomedical information are easily overlooked during discussions in MDTMs. This study aims to uncover physicians’ perceived barriers regarding the uptake of psychosocial aspects and/or patient preferences in the cancer treatment decision-making process during Multidisciplinary Oncology Consultations (MOCs), a specific type of MDTM in Belgium. Methods Between March 2019 and May 2019 semi-structured interviews were conducted with twenty medical professionals specialized in oncology. Grounded theory principles were used to detect and classify perceived barriers and patterns emerging regarding the uptake of psychosocial information in the cancer treatment decision-making process. Results Although physicians showed an open attitude towards taking into account psychosocial aspects and patient preferences in treatment decisions, the majority of respondents is not convinced the MOC is the best place to discuss these aspects. Physicians reported organisational, work process, and health system related barriers. Discussion The MOC emerges as a medicalized form of team discussion that, in its current form, does not reach its objective of truly integrated multidisciplinarity as cancer care is demanding. The working practices of the MOC can be optimized to evolve towards a truly interdisciplinary approach.

Introduction: Multidisciplinary team meetings (MDTMs) are considered best practice in the management and decision-making for cancer patients. The team typically consists of surgeons, medical oncologists, organ specialists, radiologists, pathologists and in some cases oncology specialist nurses and psychologists. They aim at evidence-based, collaborative and multidisciplinary decision-making for cancer treatment and patient management. In Belgium, the multidisciplinary approach is mandatory and formally regulated since 2003. When the Belgian Cancer Plan was launched in 2008 a specific professional group was included in this policy plan: the onco-psychologists. Preliminary study results in Flanders show that onco-psychologists do not systematically attend the MDTMs, while the results also reveal that, in addition to the oncology specialist nurses, they may facilitate the uptake of psychosocial information. To ensure that MDTMs can benefit from their diverse membership to achieve their full potential, significant attention should be devoted to the attendance and active participation of the non-medical disciplines during these meetings. The aim of this study is to explore and describe 1) the multidisciplinary character of MDTMs and 2) the (possible) role of the onco-psychologists to enhance the uptake of psychosocial information during the MDTMs. Methods: This contribution presents an observational study. 59 MDTMs are observed at inpatient medical oncology departments in five different Belgian hospitals (academic as well as general). the house? to change the working culture towards a truly integrated care approach among professionals in oncology. Limitations: The purposive sampling of inpatient medical oncology departments within two academic hospitals and three non-academic hospitals in one country, limits the generalizability of the results for broader organizational contexts and health systems. Suggestions for future research: More empirical studies are needed to reveal the reasons why MDTMs fail to fully integrate all disciplines. Also, more empirical evidence to understand how team composition, hospital culture and organizational or environmental factors can either directly affect MDTM performance or serve as key mediators to its success is needed. Lastly, interventions aiming to support the role of the onco-psychologists are crucial to enhance the input of psychosocial information.