Table 1 Characteristics of Multidisciplinary Care using three sample practices

Appointment Flow

Sequential visits

Nurse only 10 min

[Handover]

Rheumatologist 10 min

[Handover]

Nurse only 5 min (debrief)

Shared visits

Nurse only 5–10 min

Rheumatologist + Nurse 5–15 min

Nurse only 5 min

Sequential visits

Nurse only 20–30 min

[Handover]

Rheum only 20–30 min

Appointment duration

15–30 min

20–30 min

40–60 min

Role of nurses

• Patient education

• Emotional support

Rheumatologist: “There’s a myriad of stuff that the nurses do for us, a lot of education, a lot of counselling, a lot of dealing with comorbidities, a lot of issues around medication adherence.”

Nurse: “I see my role as an educator to provide the patient with the most up-to-date information, whether it’s about their medication or their disease processes or pharmaceutical, non-pharmaceutical interventions to kind of help them gain the skills that they need to work through this life-long condition”

Rheumatologist: “My nurses identify gaps in patient care that need to be dealt with and we look to make sure patients are adherent. The nurses will take about adherence, side effects and a way to mitigate it. There are many, many, many opportunities during every single visit in which the nurse, the nurses provide added care to patients”

Nurse: “I think of myself as a patient educator is what I think of myself as.”

Rheumatologist: “It saves time. I don’t have to go through every single medication with the patient … and then I think the counselling part— “You need to take this vaccine and that vaccine”— so again, that would save time and add to patient care.”

Nurse: “Education is the biggest one, I think. Then also, sometimes they’ll talk to me more than the doctor. I don’t know why, but they will open up more.”