On professionalism in the management of thyroid tumors and multidisciplinary working groups

Dear Sir,

I read attentively the article on the professional characteristics of specialists and the advantages of multidisciplinary teams in the management of thyroid cancer, by Diez et al.¹ I found the article very interesting because it reflects the opinions of many specialists involved in this field, though there are some aspects I would like to comment on:

• 1.

  Mention is made of the positivity of multidisciplinary teams, but most of those surveyed belong to hospitals, and we should not forget that their organization is established on a multidisciplinary basis. Provided the objectives for which the different services were created are being met, is such professional regrouping still needed?

• 2.

  It is stated that multidisciplinary groups allow for “patient-focused” work, in contraposition to what happens with so-called “authoritarian physicians”, who consider themselves the guardians of their patients. I believe that the fact that a group is involved does not guarantee that patients will be treated individually, and unfortunately responsibility toward the patient often proves suboptimal.²

• 3.

  The authors also state that such groups “treat diseases” in a coordinated manner and facilitate communication among professionals, but the mistake of “treating diseases” and not “people with diseases” persists in this regard, as was pointed out long ago by Hippocrates (480 BC) – the two concepts being very different. “Treating diseases” has negative consequences. One of them is the strict application of previously established protocols, obviating the desired individualization of therapies, which is obviously more complex because it requires experience on the part of the clinician, but is clearly fairer and more beneficial for the patient.³

It would be interesting to contrast this article with another study in which the users are surveyed, since the different health systems tend to only take into account the preferences of the different professional groups that work at the hospital centers, while mostly ignoring the opinions of the users.