High-res version

In this recent article we discussed the concept of ‘interprofessional communication’ in organ transplant settings (this also accounts for the lack of blog post last week – I was just too busy – so this week may be a double whammy).

Communication in medical settings is fascinating, mainly because without communication we couldn’t engage in the most basic form of health-seeking behaviour, which would be something like going to the GP or pharmacist.  In order to feel better, you have to be able to tell the doctor what ails you, and your doctor in turn needs to understand what is wrong and communicate a plan to make you feel better.

However modern medicine is actually much more complicated than a single patient communicating with a single doctor.  With something like organ transplant, providing care usually requires the expertise of a ‘multidisciplinary team’ (MDT) – seldom is a transplant patient managed exclusively by one doctor.  A number of health professionals with differing specialities comprise the MDT.  They may include surgeons, physicians, psychologists, transplant coordinators, physio and occupational therapists, nursing staff and patient educators.  With this changing face of medicine, the kind of communication required has also changed.

Of course communication between health professionals and patients is still essential, but today’s multidisciplinary medicine also requires that team members communicate with each other about the patient they are collectively managing.  This type of communication can be complicated for a number of reasons, discussed here in detail.  In brief:

• Medicine in SA is quite hierarchical, and doctors are seen to be ‘at the top of the pinnacle’ with other health professionals lower down the pecking order. This hierarchy can shape communication between the MDT, and it means that communication isn’t always as polite as it could be.
• Health professionals in the MDT don’t necessarily work in close physical proximity to each other on a daily basis. As a result messages can sometimes get mixed or messages don’t end up getting to the correct person.

In transplant, time is of the essence, and one of the main consequences of communication gaps between the MDT is that time is wasted.  This is problematic.  Without putting too fine a point on it, donor organs can only survive for so long before they start declining in quality.  When there is a donor, everyone needs sufficient information communicated to them to enable acting as fast as possible.  This includes not only the MDT, but also the patient who needs to rush to the hospital for transplant surgery.

In medical ethics, it’s always interesting to look at how changes in technology also change practice, and there seems no question that advances in medical technology have greatly benefitted patients (for instance all those patients who would certainly have died had they not received a life-saving organ transplant).  But as medicine advances, the parameters within which it takes place also need to be redefined.  Communication is essential to modern medicine, and it’s unclear whether everyone in the medical community has come to understand its importance.

The views published in this blog are entirely my own (informed) opinions.  They are open to debate, discussion and disagreement.