Rex Chin-Wei Yung, MD, Assistant Professor of Medicine, Assistant Professor of Oncology, The Johns Hopkins Hospital, Sidney Kimmel Comprehensive Cancer Center, discusses the challenges that forming a multidisciplinary team can create, particularly the introduction of the pulmonologist for treating lung cancer.

The inclusion of any new person into a group can be disruptive. There needs to be a clear reason why the new individual is an asset to the team. This needs to be clear both to the existing group and the person being added. Time is the most valuable asset and it is important that no one feels as if his or her time is being wasted.

The pulmonologist in a multimodality group needs to know they are providing a useful service to the patient. Establishing a routine and constant flow of patients can help the pulmonologist gain interest as a member.

In many groups there is a zero-sum gain feeling. If a surgeon recommends a procedure to a pulmonologist he may feel that he is missing out on an opportunity but this is not the case. In multimodality therapy there is a higher chance an issue will be detected and treated, which can result in more surgery. The end result is better treatment; surgery can be given or prevented more accurately. The primary focus should be on the welfare of the patient.