OK, spoiler alert. The answer is yes and yes. Yes, it is possible to deliver effective multidisciplinary teamwork in the private sector. And yes, it is worth it. It’s definitely easier to achieve this if you are employed by a company that has its own multidisciplinary team, but what if you work for a company of only OTs? Or what if you’re a sole trader OT? Can you still provide a multidisciplinary approach for your clients?

The answer is still yes! In this article, I’ll run through some tips about what this looks like, what some potential barriers might be, why it is worth it, and how to deliver it effectively.

What does a multidisciplinary approach look like in the private sector?

As an OT who spent the first decade of my career working in a public hospital, multidisciplinary teamwork was the norm. But if you’re an OT in the private sector who’s only ever worked for a company of just OTs, what does it look like in day-to-day practice? Here are some examples.

-          An OT may work with a physio to brainstorm the most effective transfer techniques for a person with Multiple Sclerosis, while also working in a collaborative way with the client to help them decide when it is time to start transitioning to using a powered wheelchair to make best use of their energy.

-          An OT could team-up with a speech pathologist to come up with the most effective system of switches and augmentative and alternative communication (AAC) to allow their client to maximise their ability to communicate with others.

-          An OT could collaborate with a dietitian to work out a plan for teaching the client meal preparation skills, while taking into consideration what food choices will help the client best manage their symptoms.

-          An OT may work with an exercise physiologist by sharing what we have found out about our client’s sensory preferences and what activity and environmental adaptations are effective, to maximise the client’s engagement in their exercise sessions.

-          An OT and psychologist could discuss what they are planning to write in their upcoming plan review reports for an NDIS participant, so that recommendations don’t contradict each other or so they are not seen as duplicating supports by delivering therapy that appears too similar.

There are many more allied health disciplines OTs may work with, but hopefully this gives you the idea to get you started. Feel free to share your own examples in the comments!

Why is multidisciplinary care difficult in the private sector?

These examples make it sound pretty straight forward, but it can be harder than you think, especially when each clinician works for a different company. Some barriers could include:

-          Feeling like you should be spending a participant’s limited funding on therapy sessions, rather than liaising with other health professionals.

-          Reaching out to other clinicians, but then they don’t return your calls or emails and you’re not sure why.

-          Not having a clear understanding of what the other clinician’s role might be and whether it is appropriate to refer – you don’t want to look silly, so you don’t ask.

-          The potential for conflict – what if the other clinician’s scope is overlapping with mine? What if we have completely different ideas about how to support our client?

These are all pretty valid reasons why multidisciplinary teamwork is challenging. Given the challenges we already face as health professionals, especially in systems like the NDIS, you can be forgiven for not wanting to give yourself unnecessary challenges.

So, is it actually worth it?

Given the challenges I’ve just outlined, you may be thinking, is it actually worth it? Well, jump back to the first section for a minute and re-read that. In each of those examples I provided about how we might work together, hopefully it’s pretty obvious that it could only lead to positive outcomes for the client.

Here’s a recap:

-          If we work together with a physio, our client and their care team are going to be getting a consistent message about what mobility aid they should be using, and if it’s a tricky call to make, talking it through with another clinician could help you clarify your clinical reasoning.

-          If we work together with the speech pathologist to select the right AAC device, we will be able to combine our specialist skills, while also staying within our own scope of practice, so we are more likely to select the most effective option for the client.

-          If we collaborate with the dietitian to work out what meals we should be helping our client learn to cook, we won’t be wasting our time and theirs by practicing cooking a meal they actually shouldn’t be eating.

-          If we can share our knowledge of what works with the exercise physiologist, we may save them heaps of time (not to mention potential discomfort for the client) that they otherwise would have spent using a trial-and-error approach to optimise the environment for the client’s exercise sessions.

-          And if we are on the same page as the psychologist when submitting our NDIS reports, we’re more likely to achieve the outcomes the client needs, because there will be no conflicting statements that the NDIA can use as a reason to reject our recommendations.

To me, those positive outcomes sound like teamwork could be worth it. What do you think?

Ok I’m in – but how do I do it?

If you’re not already using a multidisciplinary approach for your own caseload, hopefully this article has already made you stop and think about whether a change is needed. But now you’re probably wondering, how do I overcome those barriers you mentioned?

Having the guidance of an experienced supervisor to help you handle situations on an individual basis will always be most effective, but here are some general strategies to get you started.

-          Be open with your client about the potential benefits of a multidisciplinary approach, but ensure they are aware that any liaison or joint sessions would be billable. This will allow them to make an informed decision about whether they would like to spend their funding on these tasks, rather than you surprising them with an invoice for ‘liaison’ that they didn’t know was coming, or you absorbing the costs yourself.

-          Don’t send one email or leave one message and then write-off the other clinician if they don’t respond within a day. It may be that your email went to their junk mail, or that the person who took the message hasn’t been able to pass it on to the clinician yet. Try a few times, in a few different ways, and get the client on board (if they are able) and ask them to pass on your details to the other clinician.

-          It’s OK if you don’t fully understand what the other clinician’s scope might be. Check out their website, and if the answer isn’t there, give them a call. Ask if they would be able to cover whatever it is you are referring for, and if not, who they feel is the better clinician to handle the job. Keep in mind that often scope will overlap, so it may not always be a black and white answer, and sometimes it may even be another OT with specialist skills who is needed – this is where having supervision yourself will be helpful.

-          Don’t be scared of potential conflict, it doesn’t need to get nasty. If you think your approaches are not in alignment and it’s making things difficult for the client, you need to open up communication. And yep, you guessed it, supervision will help you prepare for uncomfortable or challenging conversations like this.

So, have I convinced you to give multidisciplinary practice a go?

If you want some more help with this topic, join the Your OT Tutor Alliance – this month’s workshop is all about effective multidisciplinary teamwork. If you miss the live session, it will be recorded and available on-demand for YOTT Alliance members.

If you found this article helpful, keep following Your OT Tutor – there are more tips, resources, and courses to come!

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