‘Effective MDT-care was likely to be goal and context specific.’
Multidisciplinary teams are one of four major primary care policy recommendations in Australia, and the evidence for them is weaker and more conditional than the policy suggests. That is the finding of a scoping review published in eClinicalMedicine, co-authored by RACGP national president Dr Michael Wright and Professor Michael Kidd, a former Australian Deputy Chief Medical Officer.
The review examined 39 peer-reviewed studies from 21 countries, published between January 2014 and August 2025. Its conclusion is that multidisciplinary team care produces ‘mixed outcomes ... driven by contextual, policy, organisational, professional and patient factors’.
The variable the review keeps returning to is relational continuity — the patient’s connection to one clinician who holds the whole picture. Where team care preserved it, the review reports gains. Where team arrangements gave patients ‘the option to see an alternative provider’ instead of their usual GP, it reports losses, and notes that ‘the larger the team, the lower the continuity of care’.
What the review found
The models studied varied widely. They ranged from ‘multiple providers working together to care for a patient’ to ‘interprofessional teams providing patients the option to see an alternative provider’. The authors note that this variation is itself part of the problem, because policy tends to treat ‘multidisciplinary team care’ as one thing.
On the positive side, the review found team care strengthened chronic disease management in some settings, and improved access. On the other side, it found team care reduced relational continuity, and described MDT arrangements ‘creating siloes of care that required additional coordination’.
Access, comprehensiveness and coordination of care were all affected — the review reports each of them moving in both directions depending on the setting.
The enablers the authors identify are specific. They include ‘shared health records with associated mechanisms for inter-team communication’, and organisational and clinical leadership. The barriers are equally specific: the review names regulatory and financial constraints as ‘key impediments’, alongside workforce shortages and high staff turnover.
‘The introduction of MDTs will require careful planning and implementation to ensure that the potential benefits of MDT are realised and that it does not compromise the quality of primary care.’
Bates et al, eClinicalMedicine, 2025
What it means for general practice
The review does not argue against team care. Its interpretation is that effective team care is ‘goal and context specific’ — that it works when it is built for a particular purpose in a particular practice, and drifts when it is adopted as a general policy direction.
The distinction that does the work is what the team is for. A team that gives a patient more clinicians to see is a different intervention from a team that gives one clinician more input to work with. The first substitutes for the GP relationship; the second feeds it. The review’s losses cluster in the first.
That reading is supported by what the authors found separating the successful settings. The enablers are about information reaching the people who need it — shared records, working channels between clinicians, leadership that makes both happen. None of them are about how many clinicians are involved.
For a GP, the practical question raised by the review is therefore not how large a team should be. It is whether the arrangement keeps the patient attached to a clinician who holds the whole picture, and whether the other clinicians’ input reaches that person.
What it does not settle
The review defines its subject narrowly: ‘MDT-care means the incorporation of additional health professionals beyond General Practitioners into primary care practices’. That is a staffing model. It is not the same thing as a scheduled multidisciplinary discussion about one patient, and the review does not examine case conferencing as a distinct intervention.
The continuity finding in particular should not be stretched. It concerns how many clinicians a patient sees in place of their usual GP, which is what the studied models varied. It is not a finding about how many clinicians may usefully contribute to a decision about a patient, and the review does not measure that.
So the findings should not be read as evidence for or against case conferencing. What they do establish is what the failure mode looks like when team care goes wrong, and what the authors found separating the settings where it worked from those where it did not: shared records, working channels between the people involved, and a clinician who retains the relationship.
A scoping review is also a map rather than a verdict. It describes what the literature covers and what it reports; it does not pool effects or rank interventions. The authors registered the protocol on OSF and searched eight databases, but the design is not built to answer whether team care works on average, and the paper does not claim it does.
About Conference.care
Conference.care is an Australian platform for running Medicare-funded case conferences, so it has an interest in how this evidence is read. The finding above is reported as the authors state it, including the parts that complicate the case for team-based care.
The model the platform supports keeps the convening clinician in the coordinating role: the GP organises the conference, claims the item, receives the advice and decides what to do with it, and remains the patient’s doctor throughout. Whether that arrangement avoids the fragmentation this review describes is not something the review tests. More on how it works is on the case conferencing and who can attend pages.
Sources
- Bates SM, Lin J, Allen LN, Wright M, Kidd M. Can multidisciplinary teams improve the quality of primary care? A scoping review. eClinicalMedicine. 2025;88:103497. doi.org/10.1016/j.eclinm.2025.103497 · open access via PubMed Central.
- Review protocol registered at the Open Science Framework, DOI 10.17605/OSF.IO/23QYU. Searches of PubMed, Cochrane, Embase, CINAHL, PAIS, Web of Science, PsycINFO and Scopus to 13 August 2025.
General information for clinicians, current at the date of publication. It is not clinical, financial or legal advice. Quotations are from the published paper; readers making decisions about practice models should read the review itself rather than rely on this summary.