Cooperation among medical specialists: “pain or gain”?

Due to the growing complexity of the health care demand and the ongoing specialization on the supply side, medical specialists have to cooperate on an increasingly frequent basis. Renee Stoffel's thesis deals with the multidisciplinary cooperation among medical specialists.

In three studies the following questions are addressed: Is there a relationship between the complexity of the health care demand and the cooperative behavior of the medical specialists during the team meetings and the evaluation of the discussions? What are the effects of multidisciplinary teamwork on the professional autonomy of the medical specialists? How do patients and the medical specialists themselves perceive the quality of the care provided by these multidisciplinary teams?

The results suggest that the complexity of the health care demand is a relevant predictor of the communication behavior of the physicians working together in a multidisciplinary team and the evaluations of their discussions. Second, multidisciplinary teamwork reduces the perceived clinical autonomy and that it has no direct relationship with the perceived domain autonomy, and first and foremost that it increases the perceived professional accountability. These effects are particularly felt by the surgical specialists. The supporting specialists, however, experience an increase in their domain autonomy. In general, patients evaluated the quality of care provided by multidisciplinary teams positively. Finally, when comparing the evaluations of the performance of the multidisciplinary teams we found that for three aspects of care physicians were more positive about their performance than their patients (i.e., patient empowerment, coordination within the team and consensus within the team).

This thesis is one of the few studies that address the daily work of physicians while focusing on the increasing importance of multidisciplinary cooperation among medical specialists. Therefore, the results of this research may prove helpful for the medical specialists themselves, those who select, train and manage them, and all others engaged in the field of medical specialties. Applying the quality of care instrument may help teams find possible areas for improvement. Insight into the relationship between complexity of health care demand and cooperative behavior may help team leaders to coordinate the discussions during the team meetings by stimulating cooperative behavior that is beneficial for achieving the team’s task.

Ms. A.M.R.R. Stoffels will be awarded her PhD in economics and business on 20 November (2.45pm). Her supervisor is prof. H.B.M. Molleman and co-promotor is dr. H. Broekhuis. Title of the thesis: Cooperation among medical specialists: “pain or gain”?