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Table 4 Research metaphors

From: Multidisciplinary cancer care in Spain, or when the function creates the organ: qualitative interview study

The "black box" This metaphor is often used by health professionals outside MD meetings because of little knowledge of their internal functioning.
"The Lone Ranger" The "Lone Ranger doing 'clinical justice' is outdated but we still have many 'Lone Rangers' riding in our health system", says one interviewee. Lone Rangers, in this context, are clinicians who unilaterally assume the management of cancer processes.
"Orchestra" vs. "Big Band Jazz" In the case of the orchestra, a multidisciplinary team requires a "baton to lead it", a few "first violins to give the health care symphony order and structure" and several "instruments" which may stand out to a greater or lesser degree but must nevertheless all play in harmony so that the ensemble sounds good as a whole. To this end, developing an internal organisation based on commonly shared rules and roles is a crucial factor. Other professionals view "Big Band Jazz" as a more appropriate metaphor. They understand the functioning of the multidisciplinary team in a much less rational and formalised way, a human group in which improvisation and voluntary actions play a key role, with individual creativity as an essential component for ensuring that the process has a good outcome.
"Partitions and walls" Professionals refer to the different metaphorical thickness of the partitions and walls to explain the mental distances that often separate them.
"Main actors, supporting (secondary) actors, and guests artists" The feeling of playing specific roles in teams varies among professionals. Some of them express their involvement in terms of being main actors, and others as supporting actors or guests artists who attend the meeting only because they are invited.
The "snowball" The large volume of visits entailed in long-term follow-up of cancer survivors, equivalent to one third of the time of activity for some professionals, leads them to refer to this process as a "snowball". In fact, one physician interviewed stated that, "you almost marry a patient with cancer".
In "no man's land" or "trapped between the two health systems" These expressions are used in cases where good practices for taking care of cancer survivors are seen to be lacking, and the current intervention model is ineffective. Primary and specialised care are organised and conceived without identifying specific needs and consistent responsibilities vis-à-vis cancer survivors.
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