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Rounds Preview: Developing True Team Medicine

Jim Molpus, for HealthLeaders Media, May 29, 2012

"Twenty-first century medicine has shifted from the solo clinical expert model to one where physicians serve as a leader of a healthcare team to focus on the total health of our patients," Compton-Phillips says. "The team works together to coordinate care seamlessly across specialties, settings, and disciplines."

When the patient engages with an entire team, it frees up all sorts of opportunities for improved outcomes and cost savings, says George C. Halvorson, chairman and CEO of Kaiser Permanente.

"Ideally you have the patient who sees their primary care site, their medical home, as their primary and central coordinating caregiver," Halvorson says. "And those sites function best if they're team-based and they've got doctors and nurses working together."

Team assignments are based on who is the most appropriate. "It doesn't necessarily have to be the physician speaking with a patient about a request for new prescriptions on the phone. Having a nurse calling and creating a little dialogue works very well and is more efficient," Halvorson says.

One of the criticisms leveled against team medicine is that it can have the adverse effect of diluting ownership, that because everyone has responsibility for the patient, no one has responsibility for the patient.

Murray Ross, PhD, vice president and director of the Kaiser Permanente Institute for Health Policy, says, "It's all about accountability. You have one entity accountable for the patient rather than five to seven entities that are all individually accountable, which means that none of them are. If there's no one in charge, there is no one to say, 'What should we be doing for this patient as a team?'"

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