Table 5 MDTM’s disadvantages. Significant quotations from the qualitative interviews. The respondent’s identifications (referring to Table 2) are in brackets

I.1.Time

“The problem is the allocated time, because the number of files has increased, recording is compulsory and we need more time to discuss complex situations”. [ID 15]

“The preparation time is substantial, but it is counterbalanced by the fact that it allows us to make a synthesis of the file”. [ID 14]

I.2. Participants’ involvement

“What unpleasant it can be when a colleague answers the phone or is not concentrating: we have important decisions to make!” [ID 7]

I.3. Quality of discussions

“The current MDTM carries the risk of being more « mechanical», we tend to apply protocols, and forget the singularity of a given situation (…), as co-morbidities, the patient’s context of life …”.[ID 19]

“There is a whole aspect of the management of the patient, which is forgotten (…) I think that discussions are limited, based on partial vision because there is only the medical approach”. [ID 3]

I.4. Limits

“In complex situations, notably in palliative decisions, most of the time the referent hematologist’s (RH) point of view will not be modified by MDTM discussions”. [ID 11]

“When a consensual proposition is not found, the RH takes the decision. But the problem is that such doctor is going to prefer the treatment X because he had bad experiences with the treatment, whereas another doctor, who have had negative experiences with the treatment Y, will prefer the treatment X… it is too subjective!”. [ID 20]

II. Disadvantages for patients

“For the patient, it is not so reassuring to know that his/her doctor chooses a treatment, whereas another doctor would make other choices, it is not very standardized, as a result, it is a random decision…”.[ID 5]

“I think that in complex situations, some MDTM decisions are not fit to the patient because psychosocial data are not taken into account”. [ID 6]