title: Practice Patterns Regarding Multidisciplinary Cancer Management and Suggestions for Further Refinement: Results from a National Survey in Korea.
abstract: OBJECTIVE
  This study was conducted to explore the process and operation of a cancer multidisciplinary team (MDT) after the reimbursement decision in Korea, and to identify ways to overcome the major barriers to effective and sustainable MDTs.
  
  
  METHODS
  Approximately 1,000 cancer specialists, including medical oncologists, surgical oncologists, radiation oncologists, pathologists, and radiologists in general hospitals in Koreawere invited to complete the survey. The questionnaire covered the following topics: organizational structure of MDTs, candidates for consulting, the clinical decision-making initiative, and responsibility for dealing with legal disputes.
  
  
  RESULTS
  We collected a total of 179 responses (18%) from physicians at institutions where an MDT approach was active. A surgical oncologist (91%), internist (90%),radiologist (89%),radiation oncologist (86%), pathologist (71%), and trainees (20%) regularly participated in MDT operations. Approximately 55% of respondents stated that MDTs met regularly. In cases of a split opinion, the physician in charge (69%) or chairperson (17%) made the final decision, and most (86%) stated they followed the final decision. About 15% and 32% of respondents were "very satisfied" and "satisfied," respectively, with the current MDT's operations. Among 38 institutional representatives, 34% responded that the MDT operation became more active and 18% stated an MDT was newly implemented after the reimbursement decision.
  
  
  CONCLUSIONS
  The reimbursement decision invigorated MDT operations in almost half of eligible hospitals. Dissatisfaction regarding current MDTs was over 50%, and the high discordance rates regarding risk sharing suggest that it is necessary to revise the current system of MDTs.
authors.affiliation: Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea.
authors.forename: Yun-Gyoo
authors.initials: YG
authors.lastname: Lee
authors.affiliation: Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea.
authors.forename: Sukjoong
authors.initials: S
authors.lastname: Oh
authors.affiliation: Institute for Health Promotion and Department of Epidemiology and Health Promotion, Graduate School of Public Health, Yonsei University, Seoul, Korea.
authors.forename: Heejin
authors.initials: H
authors.lastname: Kimm
authors.affiliation: Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea.
authors.forename: Dong-Hoe
authors.initials: DH
authors.lastname: Koo
authors.affiliation: Department of Internal Medicine, Dongguk University Ilsan Hospital, Goyang, Korea.
authors.forename: Do Yeun
authors.initials: DY
authors.lastname: Kim
authors.affiliation: Department of Internal Medicine, Veterans Health Service Medical Center, Seoul, Korea.
authors.forename: Bong-Seog
authors.initials: BS
authors.lastname: Kim
authors.affiliation: Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea.
authors.forename: Seung-Sei
authors.initials: SS
authors.lastname: Lee
mesh_terms: D000328:Adult; D000368:Aged; D000066491:Clinical Decision-Making; D019468:Disease Management; D005260:Female; D019538:Health Care Surveys; D006801:Humans; D007349:Insurance, Health, Reimbursement; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000175:diagnosis / Q000453:epidemiology* / Q000628:therapy; D010348:Patient Care Team; D010818:Practice Patterns, Physicians'; D058996:Quality Improvement; D056910:Republic of Korea / Q000453:epidemiology
keywords: Korea; Multidisciplinary; Reimbursement