Multispecialty Clinics or Tumor Boards are forums for the interdisciplinary care of cancer patients, especially those with difficult management problems or unusual manifestations of cancer. They provide a mechanism for reaching a consensus on treatment through the empirical process of testing our opinions against one another and through facts. The mechanism follows democratic principles, that is, full and equal representation of all views. The size, structure, and method of operation may vary.
WHY MULTISPECIALITY CLINIC (MSC) / TUMOR BOARD (T.B.)
- Patient Care Multispecialty Clinic / Tumor Board provides a forum for pretreatment evaluation, for resolving controversial management problems, for estimating prognosis, for staging, for planning posttreatment follow-up, and for considering rehabilitation and other supportive care.
- Consultation As an established Institution, Multispecialty Clinics / Tumor Boards promote consultations among surgical oncologist, internists, radiologists, radiation oncologists, medical oncologists and other specialists including social workers, nurses, and psychologists. Multispecialty Clinic / Tumor Board provides setting for Multispecialty consultation.
- Literature Review Physicians are also appraised of new treatment protocols through announcements available at the conference.
- Interpersonal Cooperation Multispecialty Clinic / Tumor Board can enhance interdisciplinary and interpersonnel cooperation among the medical staff. Through open interaction, the Multispecialty Clinic / Tumor Board fosters confidential exchange of views that focus on outcome, quality of care, referral patterns and practice habits. In addition, multispecialty clinic / tumor board offer opportunities to review the process of decision making in medicine, evaluate various approaches to medical education, assess knowledge and improve leadership and communication skills. By presenting follow-up data, Multispecialty Clinic / Tumor Board provides not only a feedback on the results of therapy, but also a mechanism for peer review and quality assurance.
- Educational Benefits Through participation, physicians have the opportunity to learn about new diagnostic modalities, changing treatment patterns and new patient management principles. Through didactic presentations, the Multispecialty Clinic / Tumor Board provides a setting for discussions on many issues in cancer patient management. Multispecialty Clinic / Tumor Board with its inexhaustible variety of cases is an excellent problem-oriented learning resource for Students, Interns, Residents and Practicing Physicians. By providing a forum for education, patterns of care and diffusion of new technology, Multispecialty Clinic / Tumor Board also serves as a community – level focus for the local, regional and national network of information dissemination essential for reducing cancer morbidity and mortality. Multispecialty Clinics / Tumor Boards are probably the largest source of continuing medical education.
- Other Benefits a) Unifying InfluenceMultispecialty Clinic / Tumor Board serves as a unifying influence in medical practice because they bring together the different specialties in the search of optimal treatment for a difficult disease. With its Multidisciplinary representation, no group other than the Multispecialty Clinic / Tumor Board is better prepared to treat the patient who may feel fragmented by the treatment approaches offered by the different medical Specialties. Initial Management Decisions are often critical in determining ultimate outcome.Ideally the Multispecialty Clinic / Tumor Board must be prospective with the focus on pretreatment evaluation and planning. These Clinics / Boards must be documented and must include those Cancer cases commonly seen at the institution during the year. To encompass all views on management, interdisciplinary participation is required. Without such participation, the Multispecialty Clinic / Tumor Board cannot achieve its mission. The final decisions on treatment are the responsibility of the primary treating physicians and that the opinions are only recommendations made to the treating physician by the board or conference participants.
Usually more focused on the disease site specific process, these Multispecialty Clinic / Tumor Board may consider specific technical issues as well as problems in diagnosis and patients management. Interdisciplinary approaches to patient care are also found on hospital Ethics and in Nursing.
b) Contributions to care
The resources devoted to the conduct of Multispecialty Clinic / Tumor Board should not be underestimated. These resources represent a contribution from the medical profession to cancer patient care, a contribution not widely publicized nor recognized. Resources includes the time and personal cost of physicians and other professionals in medicine who volunteer their services. The Multispecialty Clinic / Tumor Board visibly reflects the interest and the dedication of physicians, nurses and others to the care and treatment of patients with cancer.
MULTISPECIALTY CLINIC / TUMOR BOARD AS AN ESTABLISHED INSTITUTION
Multispecialty Clinic / Tumor Board is an established Institution for cancer patient care. Multispecialty Clinic / Tumor Board benefits the patients, the physicians, the professional non-medical staff, and the institution. Through the Multispecialty Clinc / Tumor Board, physicians can offer the patient most recent advances in all modalities of treatment, which is the only way to ensure maximal response, highest quality of life and survival. It has been estimated that a minimum of 60% of cancer patients stand to benefit from multidisciplinary treatment planning. Perhaps just as important, patient appreciates the concern shown by physicians when their condition is discussed at the Multispecialty Clinic / Tumor Board.
In medicine, it is difficult to resist the pressure of experience as shared through the Multispecialty Clinic / Tumor Board. When all the alternatives have been shifted, convergence of opinion becomes the accepted course of action. What matters is our loyalty to our patients, not our hope of curing all cancers. We converse at the Multispecialty Clinic / Tumor Board to make further conversation unnecessary.
- Head & Neck Services
- Breast Services
- Gastrointestinal Services
All cancer cases belonging to any specialty, any practicing physician is welcome to bring his / her case to Tumor Board for case discussion.