In Search of the Team Player

"It has become increasingly apparent that doctors have to work with other people and share the care of patients with other professions, whether they are nutritionists, pharmacists, or nurse practitioners," Dacey says. "You've got to be more collaborative, work as a team. There's a different mind-set."

Of physician leaders in healthcare organizations nationwide, 36% said the government was "most to blame for the healthcare industry mess." Another 23% blamed health plans, and 10% blamed physicians themselves.

Physicians should be blaming themselves for a big part of the healthcare morass, one physician leader suggests. "We order too much, [practice] too much defensive medicine, keep patients in hospitals too long," says Douglas Garland, MD, medical director of the MemorialCare Joint Replacement Center, part of 1,006-bed MemorialCare Health System in Long Beach, CA. "We truly care about people and good outcomes, but not in rationing care, which doctors must learn to do. We made our bed and now we must sleep in it."

Patients need to learn, too, Garland says. "They want their own doc, not a doc in the box; they want the latest and the best," says Garland, also cochair of the orthopedics, neuroscience, and rehabilitation program for the 420-licensed-bed Long Beach Memorial Medical Center.