The social worker on the medical transdisciplinary team.

Providing services to the poor and underserved is a gift. The best kept secret is that it is work that most of us are unable to leave, work that allows the practitioner to live out his or her beliefs in a world that may seem increasingly hostile to them. Work with the underserved means being able to value every individual no matter how different she or he is from you and to fight for basic human rights, including health care for all. It also means meeting many fascinating people, each with his or her own touching, funny, and brave story to tell, and getting to work with providers and staff with similar views. Today, there is a new approach to teamwork known as transdisciplinary care. This new approach has been adapted from research and business team models and transformed to respond to the many challenges of providing the best health care to the underserved. Fortunately, the clinic setting lends itself to this model, which is more efficient and cost effective than traditional staffing models and, more importantly, improves patient health and increases provider satisfaction (see Ruddy, this issue, and references therein). Transdisciplinary care involves a team of professionals who work together to share knowledge and skills across disciplines. Transdisciplinary teamwork improves communication and cooperation, and provides integrated care to the clinic’s patients. The aspect of transdisciplinary care that distinguishes it from all other team models is its emphasis on cross-training. The three goals of transdisciplinary staff development are “(1) sharing general information; (2) teaching others to make specific judgments; and (3) teaching others to perform specific actions.” The team is made up of medical providers and other professionals, including social workers, physical therapists, and patient educators. The patient, and sometimes his or her family, is also a member of the team. On a transdisciplinary team, members of different disciplines are not only proficient in their own specialties but also, through cross-training and working on the team, become knowledgeable in other specialties as well, making team members’ skills overlap. Transdisciplinary training and teamwork not only allow the provider to see a more complete picture of each patient, but also allow a single provider to assess and, in some cases, treat patients in an area other than his or her own. For example, the Association of Clinicians for the Underserved’s (ACU’s) Early Childhood Caries Prevention Project shows how a pediatrician can be trained to