Medicine
Two recent commentaries in the Annals of Family Medicine and the New England Journal of Medicine argue that the performance of modern family doctors can only be as good as their practice teams. In "The Myth of the Lone Physician: Toward a Collaborative Alternative," George Saba and colleagues explain why the myth that a primary care physician can do it all alone is dysfunctional and outdated, and should be replaced with the paradigm of a "highly functioning health care team":
What will be the roles and responsibilities of each team member? What systems and skills are needed to ensure effective communication? How will decisions be shared? How will conflict be resolved? How will the team foster trust and respect? How will the team promote the development of meaningful healing relationships? How will the team evolve over time? The specific answers to these questions define the roles and tasks of each team member, and the collaborative process of working through these challenges strengthens team relationships.
Similarly, in "Sharing the Care to Improve Access to Primary Care," Amireh Ghorob and Thomas Bodenheimer assert that the only way for physicians to meet the health care needs of a burgeoning and increasingly complex patient population is to delegate many of their traditional responsibilities - such as "patient education, lifestyle counseling, medication titration, and medication-adherence counseling" - to other health professionals:
The paradigm (culture) shift transforms the practice from an “I” to a “we” mindset. Unlike the lone-doctor-with-helpers model, in which the physician assumes all responsibility, makes all decisions, and delegates tasks to team members, but the capacity to see more patients does not increase, the “we” paradigm uses a team comprising clinicians and nonclinicians to provide care to a patient panel, with a reallocation of responsibilities, not only tasks, so that all team members contribute meaningfully to the health of their patient panel. Non-clinician team members must add capacity in order to bring demand and capacity into balance.
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Medicine
How would you rate your health care team?
Two recent commentaries in the Annals of Family Medicine and the New England Journal of Medicine argue that the performance of modern family doctors can only be as good as their practice teams. In "The Myth of the Lone Physician: Toward a Collaborative Alternative," George Saba and colleagues explain why the myth that a primary care physician can do it all alone is dysfunctional and outdated, and should be replaced with the paradigm of a "highly functioning health care team":
What will be the roles and responsibilities of each team member? What systems and skills are needed to ensure effective communication? How will decisions be shared? How will conflict be resolved? How will the team foster trust and respect? How will the team promote the development of meaningful healing relationships? How will the team evolve over time? The specific answers to these questions define the roles and tasks of each team member, and the collaborative process of working through these challenges strengthens team relationships.
Similarly, in "Sharing the Care to Improve Access to Primary Care," Amireh Ghorob and Thomas Bodenheimer assert that the only way for physicians to meet the health care needs of a burgeoning and increasingly complex patient population is to delegate many of their traditional responsibilities - such as "patient education, lifestyle counseling, medication titration, and medication-adherence counseling" - to other health professionals:
The paradigm (culture) shift transforms the practice from an “I” to a “we” mindset. Unlike the lone-doctor-with-helpers model, in which the physician assumes all responsibility, makes all decisions, and delegates tasks to team members, but the capacity to see more patients does not increase, the “we” paradigm uses a team comprising clinicians and nonclinicians to provide care to a patient panel, with a reallocation of responsibilities, not only tasks, so that all team members contribute meaningfully to the health of their patient panel. Non-clinician team members must add capacity in order to bring demand and capacity into balance.
In the current issue of Family Practice Management, Berdi Safford and Cynthia Manning discuss "Six Characteristics of Effective Practice Teams," which include shared goals; clearly defined roles; shared knowledge and skills; effective, timely communication; mutual respect; and an optimistic, can-do attitude. How many of these characteristics does your doctor's office embody? Would you say that they currently function as an effective health care team?
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A slightly modified version of the above post was first published on the AFP Community Blog.
**
A slightly modified version of the above post was first published on the AFP Community Blog.
- The Most Unheralded Posts Of 2012
It is customary for bloggers to highlight their most popular posts at year's end (see, for example, this recent compilation of posts from the AFP Community Blog, several of which subsequently appeared on Common Sense Family Doctor), but this year...
- Partnering With Community Health Workers For Better Primary Care
In developing countries, most primary health care is provided not by doctors or nurses, but by community health workers who have limited or minimal medical training. In the U.S., in contrast, most primary care services are provided by physicians with...
- Your Primary Care Team Will See You Now
In a previous post about how health reform will change your doctor's visits, I mentioned that you're likely to see your future primary care delivered by a "team" of health professionals rather than your doctor. You might be surprised to hear that...
- Medical Homes And The Meaning Of "p.c." - Part 1 Of 2
In this week's issue of Annals of Internal Medicine, Dr. Adam Goldstein writes about a disabled elderly man who died from a metastatic colorectal cancer that may have been prevented had one of his physicians referred him for a screening test at one...
- Can Primary Care Practices Be "dream Teams"?
The greatest U.S. Olympic basketball team ever assembled, dubbed the "Dream Team," dominated the rest of the world at the 1992 Summer Olympics. This team, which beat opponents by an average of 44 points en route to a gold medal, included 10 eventual NBA...