Mary C. Howell
Evaluation of the client's physical and physiological health and wellbeing is the responsibility of the physician. In an Interdisciplinary Team setting there will be an overlap of concerns and competencies for the physician and other professionals such as the nurse, social worker, clinical psychologist, and so on. In the interests of effective teamwork, it is important that the physician resist the temptation to "take over" as spokesperson or summarizer of all accumulated information. Two realms of information are the direct and predominant province of the physician: an overview of the client's past medical history and present physical status, and a physical examination.
The degree to which the physician member of an Interdisciplinary Team intervenes directly with the client depends both on the questions brought to the Team by the client's caregivers and on the availability of physicians in the client's geographical residential area. The physician's role is different when there are questions relating specifically to the client's physical well-being than when the caregivers' queries and concerns are directed solely to matters of housing, work, relations with family members, or other problems affecting well-being aside from physical health. In New England, the geographical residential area of the clients of the Kennedy Aging Project, there is no shortage of physicians; there are many physicians (both generalist and specialist) in most communities. Since every client receiving funds from Medicaid must have a yearly physical examination, most clients referred to the Team will have an identified "regular doctor," and the Team will have access to the local physician's recorded health history and physical examination, performed within the past twelve months.
The first questions to be considered by the examining physician on the Interdisciplinary Team, then, are: (1) Do the client and caregivers feel that they have a troubled relationship with their local physician? (2)