As I near the end of my third-year rotations, and I reflect on the interprofessional collaboration I have witnessed during my clerkships, there are a few experiences that stand out to me the most. These experiences have strengthened my opinion, which most in healthcare share, that interprofessional collaboration is key to medicine and patient-centered care. The collaboration that I have witnessed over the last year is strikingly different within each medical care setting, though there is not a specific “right way” in which the different professions of the medical field collaborate. What seems to matter the most is everyone’s attitude within the care team. It is when each person who participates in the patient’s care takes ownership of their piece, makes recommendations for the patient based on their training and experience, and welcomes new ideas from others that the magic of interprofessional care and collaboration happens.
While on my dermatology rotation at the VA, I experienced an interesting collaboration between one of the dermatologists and the volunteers who come into the clinic to help her. Previous research has demonstrated a link between patient-volunteer contact — via discussions or activities — and increased patient satisfaction [1], supporting increased use of volunteers as part of patient care. The dermatologist had trained volunteers to assist her, and they had been properly credentialed to volunteer at the VA. The volunteers helped to make the Veterans more comfortable in the clinic because the volunteers themselves were Veterans. The volunteers carried on conversations with patients about their military experiences and the challenges they sometimes faced after leaving the military. This addition of volunteers who connect so intimately with the patients created a very welcoming and heart-warming environment for these Veteran patients. While this heart-warming collaboration may not one we traditionally think of, it demonstrates that any collaboration can improve patient care and patient experience.
In contrast, during my family medicine rotation, I had the opportunity to experience a collaborative care clinic. The clinic where I rotated included residents, physician assistants, nurse practitioners, nutritionists, psychologists, and a dentist (located upstairs, but separate from the clinic). This clinic was an ideal primary care clinic for patients (and for a medical student who plans to go into primary care). The clinic was extremely beneficial for patients because it provided access to a multitude of services in one place. It allowed these healthcare professionals to discuss care with each other and ensure that coordination of information, care plans, and patient concerns occur in a timely and organized manner. For example, a patient with a new diagnosis of diabetes could see the physician, then have a conversation with the nutritionist regarding a diabetic diet, visit the diabetic nurse educator, and have their labs drawn all in one visit to the same office. This greatly increased the patient’s ability to handle their new diagnosis and be properly educated to manage their diabetes. These observations are supported by prior research that demonstrates that positive collaborative team interactions improve both patient care and satisfaction [2].
Lastly, my inpatient psychiatry experience exposed me to the most integrated team care I have witnessed thus far. There were biweekly meetings with the attendings, residents, medical students, nutritionists, floor nurses, social workers, and care coordinators. Within the meetings, each patient was presented to the group by their nurse, followed by the resident caring for the patient. There was then discussion of the treatment plan for the patient and their discharge disposition. Everyone was involved in the meeting, patients were carefully reviewed, and a multitude of resources were utilized to prepare the patients for their discharge. Furthermore, on the floor, many family meetings occurred, which involved the patient and their family, their doctor, and usually their social worker. This permitted for family participation and inclusion in care, which then allowed for the patient to have more support after discharge. While some of these collaborations were necessary specifically for psychiatric inpatient care, the way in which this coordination occurred on the psychiatry floor was highly beneficial for patients and would be beneficial in other fields as well. Specifically, research has concluded that collaborative care like this is pivotal in the delivery of primary care to patients who have long-term depression and other psychiatric conditions [3].
These three experiences stand out so strongly to me because they are what I would consider the current epitome of interprofessional care and collaboration. They create the vision of what an ideal collaboration should be, which is patient-centered. As I continue into my fourth year of medical school and pursue a residency in Family Medicine, I will continue to look at and analyze the collaborations within care teams, learning what works, and carrying that forward into my medical career.
- Rogers SE, Jiang K, Rogers CM, Intindola M. Strategic human resource management of volunteers and the link to hospital patient satisfaction. Nonprofit Voluntary Sector Q. 2016;45(2):409-424.
- Proudfoot J, Jayasinghe UW, Holton C, et al. Team climate for innovation: What difference does it make in general practice?.International Journal for Quality in Health Care, Volume 19, Issue 3, 1 June 2007, Pages 164–169
- Ivbijaro GO, Enum Y, Khan AA, Lam SS, Gabzdyl A. Collaborative care: models for treatment of patients with complex medical-psychiatric conditions. Curr Psychiatry Rep. 2014;16(11):506.
Madalyn Nelson is part of the 2020 class at The University of Arizona College of Medicine – Phoenix. She is an Arizona native and graduated from Xavier University where she earned her bachelor’s degree in biology. Madalyn has a passion for traveling and global health. To contact Madalyn, please email her at madalyndnelson[at]email.arizona.edu.