Interdisciplinary Care Isn’t Working the Way We Think It Is
We talk about interdisciplinary care like it is something most healthcare providers are already doing.
The therapist has a dietitian.
The dietitian has a therapist.
The psychiatrist is involved.
Everyone is technically on the same case. And yet, somehow, the patient is still the one carrying information between appointments. That is not a care team. It is a group of professionals who happen to be treating the same person.
There is a difference.
We have confused proximity with collaboration
I think this is one of the biggest problems with the way we talk about interdisciplinary care. We assume that if multiple disciplines are involved, care is automatically coordinated.
It isn't.
A therapist can be doing excellent therapy while having no idea what the dietitian is actually working on.
A dietitian can be providing excellent nutrition care without knowing what the therapist is seeing week to week.
A prescriber can be making appropriate medication decisions without having access to the information that would make those decisions more useful.
None of these clinicians are necessarily doing anything wrong.
The system is.
Most clinicians were trained to become very good at their own discipline. We were not necessarily trained to function as one coordinated clinical unit with people who have completely different training, documentation habits, terminology, workflows, and scopes of practice. So we end up with a strange version of interdisciplinary care where everyone is responsible for their piece, but nobody is responsible for making the pieces make sense together.
The patient becomes the communication system
This is probably the part that bothers me the most. The patient shouldn't have to be the bridge between their providers. But how often does that happen?
“My therapist thinks…”
“My dietitian said…”
“My psychiatrist wants to know…”
“I forgot what my other provider called it, but…”
Now the patient is responsible for remembering recommendations, translating terminology, deciding what information matters, and making sure everyone knows what everyone else is doing. And this becomes especially problematic when the clinical picture is complicated. Consider a patient struggling with eating disorder symptoms, anxiety, ADHD, medication changes, and inconsistent nutrition.
The therapist may be seeing avoidance and compulsive behaviors.
The dietitian may be seeing inadequate intake and inconsistent fueling.
The prescriber may be seeing concentration problems, sleep changes, or medication side effects.
All three perspectives matter. But if those perspectives live in three separate systems, three separate notes, and three separate conversations, we can still end up treating three different versions of the same patient.
More communication isn't necessarily the answer
This is another place where I think we sometimes make things unnecessarily complicated. When interdisciplinary care isn't working, the solution is often:
“Communicate more.”
Have another meeting.
Send another email.
Call the other provider.
Share more information.
And yes, sometimes we absolutely need more communication. But communication without structure can just create more work. A 30-minute interdisciplinary meeting doesn't magically create coordinated care if nobody knows what information actually needs to be shared. A long clinical note doesn't create collaboration if the other provider can't quickly identify what matters to their work. And sending an update isn't particularly useful if the receiving clinician doesn't know what they are supposed to do with it.
The problem isn't always that clinicians aren't communicating. Sometimes the problem is that we never built a system for the communication to actually become part of care.
We also don't speak the same clinical language
Every discipline develops its own shorthand. That's useful within a discipline. It gets messy when we're working together. The same patient can be described completely differently depending on who is documenting them.
One provider may be focused on symptoms.
Another may be focused on behaviors.
Another may be focused on nutrition status.
Another may be focused on medication response.
Again, none of those perspectives are wrong.
But without shared language and a shared understanding of the treatment plan, interdisciplinary care can become a clinical version of the telephone game.
Important information gets lost.
Context disappears.
Assumptions fill in the gaps. And eventually someone is making a clinical decision based on information that is technically available somewhere—but isn't actually accessible in a useful way.
The problem isn't that clinicians don't care about collaboration
I don't think most clinicians need to be convinced that collaboration matters. Most of us already know. The problem is that healthcare has made collaboration feel like something we have to build on top of our actual jobs.
We have our caseloads.
Our documentation.
Our scheduling.
Our billing.
Our own treatment plans.
And then we're supposed to somehow coordinate with everyone else too. So collaboration becomes an extra task instead of part of the clinical infrastructure.
That's a problem.
Because if interdisciplinary care depends on every individual clinician being exceptionally organized, exceptionally communicative, and willing to do a bunch of unpaid coordination work, the system isn't actually designed for interdisciplinary care. It's designed for individual clinicians who occasionally collaborate.
Those are not the same thing.
So what would actually need to change?
I don't think the answer is simply more meetings. We need systems that make it easier for clinicians to function as an actual care team.That means having a shared understanding of:
What each provider is responsible for
What each provider needs from the others
What information actually needs to be shared
How that information should be communicated
How treatment goals connect across disciplines
How changes in one area affect the rest of the patient's care
Who is doing what next
In other words, there needs to be infrastructure. Because the goal isn't to make therapists better at being dietitians, or dietitians better at being therapists, or prescribers better at doing everyone else's jobs. The goal is to make it easier for each clinician to do their job well while understanding how their work fits into the larger picture.
That is what coordinated care should actually mean.