Recent controversies concerning cancer misdiagnosis have highlighted 

recommendations for specialist centres and the current standard of multidisciplinary 

team (MDT) working for cancer patient care.  While MDT is often considered in the 

context of triple assessment in diagnosis, the MDT is also central to the choice of 

treatment option and patient management following the diagnosis by consensus.  

Information is being generated and communicated in new ways and patient care 

pathways are undergoing change. 

This paper examines why the MDT is now central to the diagnosis and management 

of a wide range of diseases, including cancer.  There is a shift from diagnosis by an 

individual specialist, such as pathologist, to diagnosis and disease staging  being 

agreed by team consensus at a meeting.  There is also a change in how patients are 

being managed following diagnosis. As treatments are developed and refined, modern 

management for a range of diseases may include medical, surgical, medical oncology, 

radiation oncology and intervention radiology specialities.  Paramedical specialities, 

for example nursing, dietetics and physiotherapy, occupy a growing role in patient 

management.  These treatments may be carried out in sequence, concurrently or in 

combination (of sequence / concurrent) and decisions at the MDT meeting, agreed by 

consensus, determine the protocol to be adopted in any individual patient case. 

Although responsibility for an individual patient continues to rest with an individual 

clinician, a shift is being experienced from individual clinician responsibility to group 

responsibility and accountability.  These changes in medical practice pose particular 

challenges for record keeping, at hospital and individual patient levels.