The Value of Interdisciplinary Care

Kimberly Berkovich, SPT

If you ask anyone in the field of Physical Therapy what they like about the profession or why they chose it as a career path, you will likely hear something to the effect of “I want to help people move better and optimize their function” or “I want to increase the quality of life my patients experience.”  One of the first lessons we receive in Physical Therapy school is the importance of treating the whole person and not just simply the diagnosis he or she presents with. This involves looking beyond the pathology and considering who our patients are fundamentally, what their day-to-day life looks like, what goals they have that are important to them, and what kind of activities and responsibilities they hope to return to. Understanding who our patients are helps us provide a more tailored treatment approach to achieve more meaningful goals. However, what people may not realize is that for many of our patients, Physical Therapy is just one piece of a larger healthcare puzzle. It is often through collaboration with our medical professional colleagues that we are able to provide the most holistic, comprehensive care.

Historically, medical care has been siloed, and when one specialist is not aware of what another specialist is doing with a patient, duplicate work or contradictory instructions may result. This can lead to confusion and frustration on the part of the patient, and quality of care suffers. Recently, there has been a push in healthcare to implement a more interdisciplinary approach to combat these issues.

Interdisciplinary care, as defined by the Victoria State Government, is an approach where individuals from various disciplines work together with a common purpose to “set goals, make decisions, and share resources and responsibilities.” [1] The disciplines involved in this approach can include any or all of the following: physicians, nurses, pharmacists, dieticians, occupational therapists, speech language pathologists, psychologists, social workers, neurologists, and more. The medical team, along with the patient and the patient’s family members or social support group, create a plan of care to best serve the patient.

This collaborative treatment effort is becoming increasingly utilized, and with good reason. Interdisciplinary care has been shown to reduce length of hospital stay and has been linked to improved patient outcomes and overall satisfaction of care, which is especially important in the midst of Covid-19. [1] Each discipline is specially trained to treat a unique aspect of a patient’s clinical picture, and in combination with one another, ensures that all of the patient’s medical needs are accounted for.

The best place to observe this in action is in an Inpatient Rehabilitation setting. In this setting, patients receive > 3 hours a day of intensive therapy that includes Physical, Occupational, and/or Speech Therapy, and 24-hour medical care is provided by an attending physician and nurse. Psychologists, pharmacists, and case managers are typically involved as well. The healthcare team meets at the beginning of each patient’s rehab stay to establish goals and a target discharge date, as well as to discuss any perceived barriers and how to address them. Later in the patient’s stay, another meeting is held to determine discharge criteria and the patient’s needs post-discharge. It is encouraging and heart-warming to witness this comraderie and observe how each discipline contributes their wealth of knowledge to optimize each patient’s health.

In the inpatient rehab setting, physical therapists are one of the first healthcare specialists to get patients moving after an acute life-altering event, such as a stroke, traumatic brain injury, or spinal cord injury. We have the opportunity to build relationships and rapport with these patients and witness firsthand the benefits from the interdisciplinary care they are receiving. There is something special about the moment when your previously nonverbal patient is able to communicate verbally with you thanks to the time spent with their Speech Therapist or the first time you see a patient brush their hair independently as a result of working with an Occupational Therapist. The most rewarding part about interdisciplinary care is celebrating a patient meeting all of his or her goals and getting discharged, knowing that each discipline played a part in the patient’s success.

As the U.S. population ages and the world continues to battle a global pandemic, it would be beneficial to see interdisciplinary car extended beyond hospital settings and incorporated into more outpatient practices. Hopefully we can see a bridging of the various disciplines in both the inpatient and outpatient setting going forward to provide patient-centered treatment and high-quality patient care for those who may benefit from a more holistic, comprehensive approach.

1. Department of Human Services 2008, Health independence programs guidelines, State Government, Melbourne.