Working in a multidisciplinary team: need it be so difficult?

The tensions that can exist between members of a multidisciplinary team have recently become apparent to me. As part of a rotational training scheme in psychiatry I am working with people with learning disabilities. As in many branches of psychiatry a multidisciplinary team exists to serve the needs of the patients in the hospital setting as well as in the community. The difficulties are, however, different in these two settings.

In the community team, assessments and follow up tend to be provided by the professional whose special skills are most likely to be needed. When I took up the post I was advised that the initial assessment of a new patient was ideally made by two professionals visiting jointly. In this way a more accurate assessment of needs could be made and an appropriate care package drawn up. This does not seem to happen in practice. I have never been asked to accompany anyone, nor have I been successful in arranging joint visits to patients that I have been allocated. An attempt to suggest the joint assessment of a new patient with another team member brought a written reply that “it would not be suitable.” I do not know whether this referred to the patient, the other professional, me, …