Why hold an MDT?

• Collective prioritization across a network• Equity of access to all treatment modalities• Evidence based, collective decision-making• Multidisciplinary planning of further

investigations and management• Improved patient choice• Informed consent• Justification of decisions taken

Why not hold an MDT?

• Too many patients• Too little time• Logistic issues of gathering a quorum

• Hubris

BMJ 2009;339:470

• “The challenge of providing the most appropriate care for patients is best met by a multidisciplinary team consisting of a non-invasive cardiologist, an invasive cardiologist, and a surgeon. An evidence based discussion of each option should help patients make their decision and avoid the widespread misunderstanding that PCI alters prognosis and is curative.”

Trials

• SYNTAX• BARI 2D• COURAGE

Human Rights

• Patients have the right to determine what happens to their own bodies.

• A healthcare professional who does not respect this principle may be liable both to legal action and to action by their professional body

IT IS THE PATIENT WHO IS TAKING THE RISK

Different treatments carry different risks

Is the MDT a Politically Correct Waste of Time?

•NO