The system of Multidisciplinary Tumour Boards (MDT) initiated at the Regional Cancer Centre last month will continue, with the government intervening to settle the differences between doctors and seeking a consensus over the manner of its implementation.
MDT is an internationally accepted practice of cancer management, wherein specialists from various disciplines come together to formulate a comprehensive treatment and follow-up plan for all patients.
MDT had been implemented in RCC in place of the cancer site-specific clinics following a government directive. However, the differences between doctors over its implementation was threatening to spill over to patient care.
Additional Chief Secretary Rajeev Sadanandan held discussions with all RCC departments on Friday and a consensus was reached over most issues, doctors said.
Accordingly, the RCC Director will issue a revised order on MDT.
One of the main objections raised by the radiation oncologists had been that in re-defining the clinics, their seniority and experience had been disregarded. They also objected that they were being removed from the role of primary care physicians..
“Their competence was never in doubt. The government acknowledges the expertise of clinicians in the site-specific clinics and their years of experience. However, the role of prescribing and delivering chemotherapy cannot be exclusive. Both radiation oncologists and medical oncologists will carry out the non-surgical management of patients,” Mr. Sadanandan told The Hindu .
It has been agreed that MDTs will not have a chairperson in a decision-making role and that henceforth, there will only be a convener for managing the daily functioning of MDTs.
All newly registered cases will be equally distributed among all consultants in the respective clinics and all treatment decisions should be endorsed by the MDT.
Though the main bone of contention had been who should be the primary care physician to patients, it has been agreed now that “the clinician who is going to treat the patient, as decided by the MDT, will be the primary care physician for that patient”.
At each stage of treatment, whoever is treating the patient, will be the primary care physician at that point .
The MDTs in each site-specific clinic have also been re-arranged by the RCC so that clinicians confine themselves to one speciality.
“We decided to bring in MDTs as a way forward, as part of adopting internationally accepted best practices. We need to transform the entire process of cancer care in the State by establishing clear, transparent guidelines and standards of care and this process should be led by RCC, “ Mr. Sadanandan said.
