Mediclinic Morningside’s Head and Neck Unit exemplifies collaborative excellence

Posted on 29 July 2021

“Teamwork makes the dream work” may sound like little more than a cliché, but at Mediclinic Morningside Head and Neck Unit, it’s a way of life – and the secret to this multidisciplinary team’s success.

It all started with Dr Chris Joseph, an ear nose and throat (ENT) surgeon, and Dr Robbie de Muelenaere, a radiotherapist. The pair realised that the best way to treat head and neck cancers effectively was to bring together a wide range of specialists who could support patients at every step of what can be an anxious, sometimes frightening journey. As Dr Joseph points out: “We do so much with the head and neck area; those are the main areas of sensation, of taste and smell, speech and swallowing, vision and hearing – and there’s the cosmetic factor, too.”

The unit, officially established in 2009, has developed over the years to include a multidisciplinary group of specialists: pathologists, radiologists, physicians, maxillofacial, dental, ENT surgeons, dietitians, oncologists and more. And they don’t just pass each other in the corridors or meet only in theatre. A weekly meeting brings the whole team together – virtually, in the time of COVID-19 – to discuss patient cases. The meetings offer “constant peer review”, Dr Joseph says; they’re an opportunity for radiologists to present X-rays for discussion, or for a patient’s pathology results to be viewed by all. There’s no hierarchy and every team member’s input is welcome. It’s an approach that Dr Joseph values enormously. Having practised for 30 years and trained countless students at various academic institutions, he’s adamant that there’s still plenty to learn.

“You’re learning all the time. When you’re in a multidisciplinary area, you can’t keep up with everybody, so you’re always learning from everyone in the team, in different areas. It’s rewarding to be part of a team.”

Patients, of course, also benefit from this approach, receiving world-class support before, during and after surgery and throughout the broader treatment journey. Even now, when the impact of COVID-19 sometimes demands different approaches, the team collaborates to identify when treatment can be modified, changed or delayed without having a negative impact on the patient.

“Patients need to be with a team because it reassures them that they’re getting input from a whole group of people rather than just one person,” Dr Joseph says.

He believes the unit’s multidisciplinary approach will eventually become the norm as medical experts step away from solo practice to work in collaborative teams. Apart from the obvious benefits for specialists and patients, there’s a value incentive, too. Such units and teams can create bundled payment options so patients and funders know what every step of the treatment process will cost before it begins. This model has been trialled in some parts of the United States.

“The idea is to move away from co-payments. Using a quality multidisciplinary team makes it a cost-effective option.” Dr Joseph says.

Succession planning and skills development are also central to the Head and Neck Unit’s approach. The unit is currently developing paid fellowships with a similar multidisciplinary team in Pretoria – recipients will work for two years between the groups before writing the International Federation of Head and Neck Oncology Societies’ exam. Dr Joseph says more and more private clinical groups in South Africa will begin training specialists, ensuring that the shoes of the country’s already world-class medical fraternity are being filled for decades to come.



Published in Innovation