Tumor Board Essay

Tumor Boards and Multidisciplinary Physicians: An Ethnographic Inquiry of the Influence of Social Hierarchy on Cancer Treatment Decision-Making

Abstract

The purpose of hospital tumor boards is for multiple specialists together to find the best treatment program for patients, but decision outcomes do not always represent the multispecialty perspectives within the board. Scholars have found that multidisciplinary tumor board groups are not always effective in delivering their expected output and suggest many practical barriers exist to effectiveness. Recent research has investigated aspects of interdependencies among healthcare workers, but we still know little about the culture and structure of individual tumor boards and the subsequent effect

For this reason, decisions about the best treatment options for cancer patients are often made by these multidisciplinary teams, also known as physician-run hospital tumor boards. Tumor boards are formal meetings where relevant, key specialists with different backgrounds, norms, beliefs, values, learned operating models and practices meet to discuss the diagnosis and management of patients with cancer (El Saghir et al, 2014). Because tumor boards often deal with more than one type of cancer, members collaborate with others who have specialized knowledge of oncology and physiology (Fleissig et al, 2006). Members often include, but are not limited to, surgeons, medical oncologists, radiologists, interventional radiologists, radiation oncologists, pathologists, oncology nurses, behavioral specialists, specialty physicians such as gynecologists or pulmonologists, and in few cases, patient-care coordinators. The team composition varies depending on cancer type, since certain cancers specific to an organ or disease require a specialist to participate to make the best decision (Fleissig et al., 2006). Additionally, the structure of clinician involvement varies by specialty and hospital

EST and SCT were used to understand the social phenomenon of social hierarchy which emerged in the data shown to affect the interaction and decision-making process for cancer patients. Together, they provide a useful lens through which to explore the research question and interpret the study findings, as well as an explanatory framework for hierarchical development and sustainment within goal-focused multidisciplinary groups. Both theories were chosen because combined, they best explain how social hierarchies are present, how they are formed and how they influence behavior in goal-oriented groups. The basic assumptions of the theories are presented