多学科协作(MDT)

多学科协作（MDT）——通向医学未来的必经阶段CentralGovernmentForbiddenCityWomen&ChildrenInternalMed&SurgeryOutpatient&ERStatecouncilCPCheadquarter1915Megatrends现代医学诊疗模式大趋势传统模式：单学科诊疗（看人生的病）必经阶段：多学科协作（看生病的人）多学科协作Multidisciplinaryteamwork(MDT)MDT是国际顶尖综合医院和专科医院的共识•Cambridge(1766):Atleast2or3roundsofMDTdisscusionforeachcancerpatient.•Mass.General(1811):Unitespecialistsacrossthehospitaltoofferpatientscomprehensive,state-of-the-artmedicalcare.•MayoClinic(1863):Providingthebestcaretoeverypatientthroughintegratedclinicalpractice,educationandresearch.•JohnsHopkins(1879):Providingpatient-centeredmedicinetoprevent,diagnoseandtreathumanillness.•MDAnderson(1941):Multidisciplinary,research-drivenpatientcarethroughouteachphaseofthecancercarecycle.MDT的核心理念•以病人为中心•针对特定疾病，依托多学科团队，制定规范化、个体化、连续性的综合治疗方案。MDT的核心目标•为患者设计最佳诊疗方案，确保最佳疗效。•提升学科的诊疗能力和学术水平。•医教研健康管理真正融合，推动医学科学进步。MDT适用于各个学科•例如：我院内分泌科：以多学科协作为特色的理念甲状腺疾病会诊中心（内分泌、外科、眼科、妇产科、核医学）糖尿病足防治中心（内分泌、整形、血管外科、骨科、社区医院）妊娠糖尿病产后随访门诊（内分泌、产科）糖尿病并发症筛查和治疗随访门诊（内分泌、肾内、心内、眼科）肥胖和糖尿病前期管理门诊（内分泌、营养）内分泌高血压专业门诊（内分泌、泌尿外科、影像、神外、介入）MDT适用于各个学科MDT适用于各个学科肿瘤治疗是典型的例证今年80岁，有严重的冠心病、肺气肿，刚刚被确诊前列腺癌，我该怎么办？假如我是患者传统医疗模式下，医患双方的共同困惑•关于医院的选择：–综合医院能治好我的肿瘤吗？–专科医院能保证我的医疗安全吗？•关于前列腺癌：–就诊科室或医生不同，治疗方案差异巨大–多种治疗方法可选：手术、放疗、介入、冷冻、化疗、内分泌治疗、靶向治疗、生物治疗等–不同治疗方法各有优缺点–对单一学科/医生的治疗效果有所担忧•关于高龄及心肺疾病：–如何平稳控制，耐受各项治疗措施？MDT是医患双方的必然选择通过MDT，与患者充分沟通，为患者找到最适合病情的科学合理的综合诊疗方案，在保证医疗安全的前提下使患者获得最佳疗效。综合医院案例：MDTatMass.General•Centersandservices–MultidisciplinaryCareCenters•CancerCenter就诊途径一•CriticalCareCenter•DigestiveHealthcareCenter•HeartCenter•MassGeneralHospitalforChildren•TransplantCenter•VascularCenter–Alldepartments•DepartmentofUrology就诊途径二就诊途径一：TheCancerCenter•TheCancerCenter:–Offersacoordinatedteamapproachtailoredtotheindividualneedsofeachpatient。–Totally39treatmentprograms.•ProstateCancerProstateCancer：MultidisciplinaryPatientCare•Newpatientsaregenerallyseenwithintwoweeksofreferral.•Atyourfirstappointment,youwillmeetthegenitourinarycancerspecialistswhowillbeinvolvedinyourcare.•Thesespecialistsmayinclude:–Urologistsandsurgicaloncologistsexperiencedinthelatestprostatecancersurgeryapproaches,includinglaparoscopicandroboticsurgery–RadiationOncologistswhospecializeindeliveringtheoptimaltherapeuticdosewhileprotectinghealthytissue–MedicalOncologiststoprescribethemosteffectivetreatments,includinghormonetherapy,chemotherapyandimmunotherapy•Inaddition,youmayalsosee:–Pathologistsspecializinginurologiccancers–Radiologistsspecializingingenitourinarycancerimaging–Oncologynursesandnursepractitionerswhospecializeincancercare–Oncologypsychiatristsandsocialworkersexperiencedinhelpingwiththecognitivesideeffectsofcancerandtreatment,aswelltheemotionalandspiritualsideofthecancerexperience–Anutritionisttohelpyouwithquestionsaboutdietandnutritionduringtreatment–Palliativecareproviderstoimprovequalityoflife•Thisteamwillworkwithyoutodevelopatreatmentplanthatbalancespotentialsideeffectsandbenefitsoftreatment.Theywillcontinuetomonitoryourcareandcommunicateregularlywithyouandyourreferringphysicianaboutyourprogress.就诊途径二：DepartmentofUrology•Treatments&Services–Cancer:Bladder,Kidney,Penile,ProstateandTesticularCancerProgram–ErectileDysfunctionService–FemaleUrologyProgram–GeriatricUrologyProgram–KidneyStoneProgram•Compassionate&PersonalizedCare•Oururologistsworkcloselywithallofthecliniciansoneachpatient'streatmentteam,acomprehensiveandhighlycoordinatedapproachmanagedthroughtheworld-renownedMassGeneralCancerCenter.•Dependingonyourillnessanddiagnosis,yourtreatmentteamincludesyoururologistalongwithmedicaloncologists,radiationoncologists,radiologistsandpathologists.•YoualsohaveaccesstothewidevarietyofresourcesandsupportservicesavailablethroughtheCancerCenter.•UnitespecialistsacrossthehospitaltogiveConsultationsandsupportservicestoensurewedeliverthehighestqualityandsafestcarepossible.如何为高龄及心肺疾患保驾护航专科医院案例：MDTatMDAnderson–Brain&SpineCenter–BreastCenter–ColorectalCenter–EndocrineCenter–GastrointestinalCenter–GenitourinaryCenter就诊途径–GynecologicOncologyCenter–Head&NeckCenter–LeukemiaCenter–Lymphoma&MyelomaCenter–Melanoma&SkinCenter–SarcomaCenter–ThoracicCenterMultidisciplinaryCancerCareCenters：MostofthenewpatientswhocometoMDAndersoneveryyeararetreatedinoneofourspecializedCancerCareCentersorclinics,whichembodytheteamapproachtocancercarethathasbecomeanMDAndersontrademark就诊途径：GenitourinaryCancerCenter•MDAnderson’sGenitourinary(GU)CancerCenterprovidespersonalizedcareforcancersoftheurinarytractandmalegenitaltract.ThecenterisoneofthemostactiveprogramsinthecountryforGUcancers.Ourgoalistocontrolthecancerandpreservethebestqualityoflifeaftertreatmentfor:–Prostatecancer–Bladdercancer–Kidneycancer–Testicularcancer–Penilecancer–Nonmalignanttumorsoftheurinarytractandmalereproductivesystem–VonHippelLindaudisease(VHL)•WhyChooseMDAnderson'sGenitourinaryCenter?–Most-advancedgenitourinarycancertreatmentsincludingprotontherapy,genetherapyandtargetedtherapies–Advancedsurgicaltechniquesincludinglaser,cryosurgeryandroboticlaparoscopicprocedures–Highlyspecializedteamofexperts–Dedicationtomaintainingoptimumfunctionandqualityoflife–R