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There is no ‘i’ in ‘team’

By Rebecca Cox

Success in almost every sector involves the collaboration of many different disciplines; the expertise of each utilized to produce the best end result or outcome. The IME team has had numerous successes (not a marketing plug, I promise) which would not have been possible without the input from numerous specialists inside and outside of our tiny but mighty team.

The effective collaboration of different specialists is perhaps most crucial within healthcare because ultimately we are talking about a person’s life, or quality of life as the outcome. The focus on integrated healthcare has been steadily gaining momentum over the past 30 years; however, the concept of multidisciplinary working was in fact realized at the turn of the 20th century by the Mayo brothers.

It has become necessary to develop medicine as a cooperative science; the clinician, the specialist, and the laboratory workers uniting for the good of the patient, each assisting in elucidation of the problem at hand, and each dependent upon the other for support.”—William J. Mayo, 1910.

The Mayo Clinic Model of Care aimed to support the delivery of coordinated patient care through the effective teamwork of diverse healthcare specialists and disciplines, and move away from silo practices. The concept of multidisciplinary teamwork has come a long way since then; as knowledge expands, clinical care becomes more complex, creating more sub-disciplines and advanced health services. Bringing together this diversity of healthcare professionals working toward a similar goal can not only have a beneficial impact on patient outcomes, but also reduce the pressure for the healthcare professionals themselves.

An aging population and increase in chronic diseases means effective integration and communication between specialties has never been more important. Chronic kidney disease (CKD) is one of many multimorbid conditions that are on the rise globally, with the prevalence having increased by almost a third over the past 30 years.1 It is a leading cause of mortality and morbidity, largely due to its association with complications that affect all body systems.2 Successful management, that is the prevention of progression to end-stage renal failure, requires the skillset of several disciplines, including primary care in which early CKD and its comorbidities is often managed.

Different specialties tend to have their own guidelines and, being time poor, find it difficult to keep informed of novel treatments within their immediate field, let alone outside of it. For such a complex and multifaceted condition, the multidisciplinary team (MDT) need to be aligned on evidence-based best practice for CKD and all its comorbidities.

Education is traditionally aimed at one discipline at a time, therefore providing little opportunity to note the potential differences between guidance and discuss the alignment of management to avoid creating incredibly complex treatment plans that patients find hard to adhere to.

In our new program, the Multidisciplinary Management of CKD, we look to plug this gap. Involving a nephrologist, cardiologist, endocrinologist, and primary care practitioner; and with perspectives from the wider MDT; we will follow a patient with CKD and multiple comorbidities to highlight the benefits of effective communication and collaboration to reduce the management burden for both the healthcare professionals and the patient.

See for yourselves, view our program


  1. GBD Chronic Kidney Disease Collaboration. Lancet 2020; 395: 709–733.
  2. MacRae C, Mercer S, Guthrie B and Henderson D. Br J Gen Pract 2021; 71: e243–e249.