Bioethics Blogs

In the Journals — February 2016, Part II by Aaron Seaman

And now for a very belated February post (not even the extra day could help this year…). However, there is much to dig in to here, including two special issues, “The Sociology of Health Care Safety and Quality” in Sociology of Health & Illness and “Anthropology and Medical Photography: Ethnographic, Critical and Comparative Perspectives” in Visual Anthropology. Enjoy!

Social Science & Medicine

Invisible walls within multidisciplinary teams: Disciplinary boundaries and their effects on integrated care

Elisa Giulia Liberati, Mara Gorli, Giuseppe Scaratti

Delivery of interdisciplinary integrated care is central to contemporary health policy. Hospitals worldwide are therefore attempting to move away from a functional organisation of care, built around discipline-based specialisation, towards an approach of delivering care through multidisciplinary teams. However, the mere existence of such teams may not guarantee integrated and collaborative work across medical disciplines, which can be hindered by boundaries between and within professions. This paper analyses the boundaries that affect collaboration and care integration in newly created multidisciplinary teams. Empirical data are drawn from an ethnographic research conducted in the sub-intensive stroke unit of an Italian public hospital. Data collection involved 180 h of observations and conversations with 42 healthcare providers. Findings show that disciplinary boundaries hinder both intra-professional and inter-professional collaboration. Doctors from different disciplines adopt different, and sometimes conflicting, clinical approaches, doctors and nurses construct discipline-specific professional identities, and conflicts emerge between doctors and nurses from different disciplines over the regulation of the medical–nursing boundary. Achieving collaboration and integration between professionals from different disciplines may be particularly challenging when the group with less institutional power (nurses, in this case) has developed a high level of expertise on the needs of the patients targeted by the team.

The views, opinions and positions expressed by these authors and blogs are theirs and do not necessarily represent that of the Bioethics Research Library and Kennedy Institute of Ethics or Georgetown University.