working together

A question of discipline

Throughout many of our professional spheres of practice and research, we would be very familiar with the term multidisciplinary. It is very commonly used to describe the team meetings within health facilities where doctors, nurses and allied health professionals come together to talk about common patients, or receive insights from other professional perspectives around how to approach complex management. This clearly adds value to health management since it promotes the sharing of different insights, priorities and attitudes around the same presenting circumstance. However, multidisciplinarity has its drawbacks.

Typically in a multidisciplinary approach, practitioners will each review a patient or professional circumstance in isolation, and then come together to discuss findings and collaborate around the direction in which to proceed. This lends itself to isolation of perspective and “siloed” practice, where each type of professional is reasonably independent in their active consideration and development of planning around the case in question. Interdisciplinary provides an approach that promotes a shift away from siloed practice, to create a genuinely collaborative means through which complex problems can be solved. It is a term traditionally coined throughout research methodologies, but could equally be applied within clinical health practices. Within an interdisciplinary approach, practitioners from all fields are embraced for the value of their input, as much as the output from their assessments. In contrast to a typical multidisciplinary approach, where perspectives from diverse disciplines are incorporated after they have reviewed a professional problem, interdisciplinarity involves the representation of diverse disciplines prior to, and throughout the workflow process. In this way, the diversity of perspective can be considered along the way, then influence or integrate with each individual discipline’s input.

The value of each individual discipline’s expertise therefore, has the opportunity to be clearly heard, appreciated, and incorporated into the collective problem-solving process. Furthermore, such collaboration allows the value of each individual discipline’s perspective to be considered relative to the value of other discipline perspectives. Resultantly, an interdisciplinary activity is ideally more dynamic and fluid, emphasising the process of interaction rather than the outcome. Clearly the outcome of any problem-solving activity is of great importance. Arguably, an interdisciplinary process is more likely to result in an outcome that is more genuinely representative of the numerous perspectives involved, because it promotes more active participation of contributors. Outcomes from other processes might be more akin to a conglomeration of perspectives without a genuinely incorporated voice from individual participants. In this sense, an interdisciplinary process could be thought of as the creation of an “n+1” space, where n is the number of disciplinary perspectives or representatives within a working group. Through an interdisciplinary approach, a space that is independent of each of those contributing perspectives is created. It still contains and represents each contributory discipline, but the overall approach taken by the collective, is unique; it adopts a novel perspective towards the problem or circumstance. It could be thought of as a perspective that is simultaneously all yet none of the contributing discipline perspectives.

Around the world, Lifestyle Medicine is gaining traction, and each country organises their professional organisations and practitioners in different ways. This is in part due to the local culture; part due to prevailing energies of individual organisations; and part due to the socio-political structures within local health and education sectors. Within the Australasian Society of Lifestyle Medicine (ASLM), we promote Lifestyle Medicine as a contextual focus towards health, with an attempt to direct our primary energies towards the broader influences of health and illness. This construct strongly emphasises the social determinants of health, and chronic disease determinants or anthropogensWith such a sociocultural perspective towards the field, it is no surprise that an interdisciplinary approach is promoted. If health is to be influenced throughout such proximal associations, there needs to be a strong collaboration across sectors both throughout, as well as outside of health. This needs to be an effective professional interaction, where each discipline’s expertise contributes and builds around the others to achieve a richness and impact of influence that is greater than the sum of their parts. Furthermore, an interdisciplinary approach provides a valuable opportunity for the voices of patient, recipient or community representatives to be incorporated into the discussion as well. Often professional activities take place in isolation from the space that they are intending to influence, and are then ‘transplanted’ into the ‘real world’ scenario. Interdisciplinarity provides a forum for interaction to be truly representative and incorporative of the context within which its activities take place.

Lifestyle Medicine spans the entire spectrum of health influence: from the specific levers of behavioural change within unique individuals; to the advocacy for political decisions that influence the diverse social drivers of systems and environments that influence ‘traditional health interactions’. Some professional disciplines promote expertise around one end of this spectrum or the other. For this entire spectrum to be truly influenced, there needs to be genuine representation, and effective interaction between such disciplines. An interdisciplinary approach is more likely to achieve this than traditionally independent models of professional processes.

Of course, such an approach is not likely to be easy or straightforward. Every professional discipline and individual perspective comes with its own history, politics, belief structure, and heuristic that influences our world view and problem-solving approach. There is no way that we are all going to agree with one another all the time! Yet debate and uncertainty are the cornerstone of scientific enquiry, and should be embraced rather than baulked from. Complex problems require diversity and flexibility to be successfully surmounted. Through adopting an interdisciplinary approach to solving professional problems, we should be able to rise above our intrinsic professional biases and presumptions; we are likely to learn something new about a different professional perspective; we might be able to gain some humility and inter-professional respect…and surely would also have more likelihood of effectively and comprehensively solving the problem!

Interested in learning more about Lifestyle Medicine?