Doctors and patients exchange a contract for treatment, and the doctor becomes responsible for the treatment, excluding long-term care insurance and some other medical practices. The doctor must take responsibility for the outcome of the treatment, even when it is conducted in the context of team medicine. As team medicine has become an essential element in psychiatry, we are in the position to continue the discussion regarding the roles of doctors in team medicine. In reference to my own experience and knowledge, I will discuss how team medicine should be practiced, especially in "treatment-planning formulation", and how it should be developed by focusing on the roles of doctors in team medicine from the perspective of psychiatry.
Treatment planning needs to designate outcomes that lead to the ultimate goal by which the patient recovers their life as they know it, and it should take into account several conditions, including feasibility. Information collected by team members during the process of treatment is extremely helpful, and a plan designed around such information is more appropriate than that based on subjective judgement and personal experiences. Furthermore, team members involved in treatment planning from respective specialties help in the process of formulation.
Treatment-planning formulation is effective when a management cycle is employed, which starts with each team member's evaluation from the perspective their respective specialty. In medicine, the PDCA cycle, where planning leads to doing, which leads to checking and finally to acting, is important. I propose a revision, and suggest a cycle comprising assessment, needs, planning, discussion, doing, monitoring and reassessment. I believe that this cycle is more effective, and it assists flexible reevaluation of the treatment goals and treatment plan.
In order for this management cycle to be carried out smoothly, cooperation and leadership skills are required by doctors involved in team medicine.
<Author's abstract>
Discussion of Psychiatric Team Medicine: Treatment-planning Formulation and the Roles of Doctors
Matsubara Hospital
Psychiatria et Neurologia Japonica
121: 55-63, 2019
<Keywords:multi-disciplinary collaboration, team medicine, treatment planning, roles of a doctor, care process>