A multidisciplinary approach may ‘unlock the solution’ for treating complex GI cases
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In this month’s issue, we are highlighting the important topic of multidisciplinary care of our gastroenterology patients.
For those with inflammatory bowel disease or irritable bowel syndrome, there is increasing recognition of the importance of diet and behavioral therapy as adjunctive treatments. Medication alone is often not the complete answer.
Source: Edward V. Loftus Jr., MD
As the cover story discusses, there are emerging data suggesting that a more integrative or holistic approach not only improves patient care, including the use of fewer corticosteroids and opioids, but also might reduce health care utilization, such as emergency department services and the proverbial unwanted CT scan, and save money. However, barriers such as access to dietitians and psychologists or reimbursement for their services, can still exist.
How can one begin to utilize multidisciplinary care in one’s practice? As a first step, collaborate with the surgeons, radiologists and pathologists you work with most to arrange a regularly scheduled conference to discuss complex cases. Many centers, including Mayo Clinic, have found this to be invaluable. Getting the perspective and wisdom of colleagues not only in other specialties but our own can sometimes unlock the solution for a complex patient.
The next step would be to identify a GI dietitian and GI psychologist to consult on your patients. For example, when a patient wonders whether diet or stress could be playing a role in their symptoms, you could provide them your own “spiel” on the topic, but a dedicated specialist in that area would probably obtain a better history on the issue from the patient and then provide a more detailed solution.
If this is not feasible for your practice, there are now companies, as mentioned in the article, that can provide some of these services for your patients virtually. I have given some of my patients the names of providers outside of our center, since this can be done virtually, and the feedback that I have received has been positive.
If you are really feeling ambitious, some centers have developed medical homes for their GI patients, embedding dietitians and psychologists into their daily practices.
- For more information:
- Edward V. Loftus Jr., MD, is Healio Gastroenterology’s chief medical editor and the Maxine and Jack Zarrow Family Professor of Gastroenterology at the Mayo Clinic. He can be reached at loftus.edward@mayo.edu.
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