List Henriette, Kristensen Dorthe Brogård, Graumann Ole
Clinical Department, University of Southern Denmark, Winsløwparken 19, Odense C, 5000, Denmark.
Department of Business and Management, University of Southern Denmark, Campusvej 55, Odense M, 5230, Denmark.
Soc Sci Med. 2025 Apr;371:117886. doi: 10.1016/j.socscimed.2025.117886. Epub 2025 Feb 26.
Multidisciplinary team meetings (MDMs), also known as tumor boards, play a crucial role in collaborative decision-making within Western healthcare systems. This study explores the significance of MDMs in Danish cancer care through an ethnographic lens, based on fieldwork conducted at five university hospitals. Clinicians regard these meetings as fostering efficiency, reflexivity, consistency, transparency, and security in patient care, and recognize MDMs as "the highest decision-making level" in cancer care. Analytically, we conceptualize MDMs as boundary spaces where professionals engage in collaborative boundary work across disciplines. We introduce a typology of this work-calibrating, reflecting, and guarding-which are conducted before, during, and in relation to MDMs. Our analysis demonstrates how these practices afford relational agency as an enhanced form of individual agency. At the same time, we uncover how these practices establish "gate mechanisms" that privilege certain voices, knowledge, and expertise within the boundary space. This reconfigures professional identities and power dynamics, shaping a specific treatment and care regime as decisions are collectively made by a confined group of clinical actors.
多学科团队会议（MDMs），也被称为肿瘤专家委员会，在西方医疗体系的协作决策中发挥着关键作用。本研究基于在五所大学医院开展的实地调查，通过人种志视角探讨了MDMs在丹麦癌症护理中的重要性。临床医生认为这些会议有助于提高患者护理的效率、反思性、一致性、透明度和安全性，并将MDMs视为癌症护理中的“最高决策层面”。从分析的角度来看，我们将MDMs概念化为边界空间，专业人员在其中跨学科开展协作性的边界工作。我们介绍了这种工作的一种类型学——校准、反思和守护——这些工作在MDMs之前、期间以及与MDMs相关的过程中进行。我们的分析展示了这些实践如何赋予关系能动性，作为个体能动性的一种强化形式。与此同时，我们揭示了这些实践如何建立“把关机制”，在边界空间内赋予某些声音、知识和专业技能以特权。这重新配置了专业身份和权力动态，随着决策由一群特定的临床行为者集体做出，塑造了一种特定的治疗和护理模式。
