What Interdisciplinary Care Should Actually Look Like
If we're going to say “interdisciplinary care,” I think we should be a little more demanding about what that actually means. Because having three clinicians involved in a patient's care does not automatically make those clinicians a care team.
A care team should function like a team.
That sounds obvious. It also turns out to be surprisingly difficult to do in healthcare.
Start with the patient, not the professions
The easiest way to accidentally create fragmented care is to build the treatment plan around the disciplines involved.
Therapy has its goals.
Nutrition has its goals.
Psychiatry has its goals.
Then we put them next to each other and call it collaborative care. I think we should flip that.
Start with the patient.
What is happening?
What are we trying to change?
What does the patient need?
What does each clinician uniquely bring to that problem?
And where do those pieces overlap?
The point of interdisciplinary care isn't for everyone to have a piece of the patient. It's for the team to understand the whole picture while each clinician remains responsible for their own area of expertise.
Everyone should know what everyone else is doing
Not every clinician needs every detail. That's an important distinction. Good collaboration isn't about dumping every note, every conversation, and every piece of clinical information onto the rest of the team.
It's about making the right information visible to the right people at the right time.
A therapist should be able to understand the nutrition priorities that affect therapy.
A dietitian should understand the behavioral or psychiatric factors that affect nutrition treatment.
A prescriber should know about meaningful changes that could affect medication decisions.
And everyone should know what the current treatment priorities are.
That doesn't require everyone to practice everyone else's discipline. It requires enough shared context to make good decisions.
There should be a shared treatment picture
This is one of the biggest differences between “multiple providers” and an actual care team. Everyone should be able to answer:
What are we treating?
What are we working toward?
What is getting in the way?
What is each person doing about it?
What has changed?
What does the team need to know next?
If those answers are completely different depending on which provider you ask, you're probably not looking at coordinated care yet. And this doesn't have to mean creating another enormous document that nobody wants to maintain. It can be simple. The important thing is that the team has a shared clinical picture.
Build communication into the workflow
This is where I think we need to stop relying so heavily on individual effort. If the only way a therapist and dietitian communicate is when one of them remembers to send an email, we don't have a reliable system. If providers have to schedule a separate meeting every time something changes, that isn't particularly scalable. If the patient has to carry the information between appointments, we've put the coordination burden in the wrong place.
Communication should have a home.
There should be a predictable way to communicate changes, questions, concerns, and next steps. And it should be built into the workflow instead of treated as an optional extra.
Give each discipline a clear role
Good interdisciplinary care does not mean blurring professional boundaries. Actually, I think the opposite is true. The clearer everyone's role is, the easier it becomes to collaborate.
The therapist doesn't need to become the dietitian.
The dietitian doesn't need to become the therapist.
The prescriber doesn't need to manage every aspect of the patient's behavioral health.
Each clinician should be able to say:
This is my area.
This is what I'm seeing.
This is what I'm doing.
This is what I need my colleagues to know.
This is where I need their expertise.
That creates something much more useful than everyone trying to do a little bit of everything. It creates a team of specialists who can actually see the same patient.
And we need better tools
I don't think clinicians need another lecture about how important collaboration is. We need practical tools that make collaboration easier.
Shared intake and assessment structures.
Clear roles and responsibilities.
Consistent communication workflows.
Templates that help clinicians communicate clinically meaningful information without writing an entirely separate essay.
Treatment planning systems that account for more than one discipline.
A shared vocabulary.
And training that teaches clinicians not just why interdisciplinary care matters, but how to actually do it.
Because “collaborate with the treatment team” is not a workflow.
And clinicians deserve better than instructions that assume the infrastructure already exists.
A practical exercise you can use this week
If you work with another clinician regularly, try this:
Take one current patient and answer these five questions separately before you talk to the other provider:
What do I think is the most important clinical problem right now?
What am I currently doing about it?
What has changed recently?
What do I need the other provider to know?
What do I need from the other provider?
Then compare your answers.
Not to see who is right.
To see where your clinical pictures overlap and where they don't.
That gap is often where the most important coordination work lives.
This is the part I think healthcare keeps getting backwards
We don't need every clinician to become an expert in every discipline. We need clinicians to be better at working with other disciplines.
It requires shared language, clear roles, practical systems, and infrastructure that makes coordinated care possible without asking clinicians to spend another two hours every week doing unpaid administrative work.
That's the kind of interdisciplinary care I think we should be building. Not more people involved in a patient's care.
A better team around the patient.