Redesigning Clinical Workflows to Return Joy to Patient Care
Team Care in Health Care
Team Care in Health Care

Why should we pursue Team Care in health care?

Is it to prevent physician burnout?  Or is it to support population health?

The answer is “Yes, it’s both.”

Team care can help you do well in your profession and give you back the work-life balance needed to have a successful home life as well.

What is Team Care?

If you are not familiar with team care, I’m happy to explain. It is a way to redesign a physician’s office staffing that provides additional support to help the physician – and can include an extended team of various professionals to provide additional services, including pharmacists to reconcile medications, case managers to help reduce readmissions, and behavioral health providers to manage psycho-social issues.

“But wait!” you might say. Won’t this simply increase the cost of delivering care at a time when many practices are barely surviving financially? It might, if nothing else changes.  So let’s look at what changes if we do it right.

The Benefits of Team Care

It’s become common now for primary care physicians to see under 20 patients a day.  There was a time, not so long ago, that PCPs saw 30 patients a day. And at the end of that day they did not face an evening tethered to their keyboard at home catching up on visit notes and overflowing inbaskets. But times have changed. In the “good old days” chart notes were handwritten (OK, scrawled) or dictated, prescription refills required five seconds for a quick flick of a signature, medication reconciliation was less complex (fewer meds), preventive and chronic care gaps were not identified, attestation did not exist, and prior authorizations, when requested, were rare.

Hard to believe that was the case for most physicians 15 years ago. Back then, we didn’t need a full team to support us.  Well, times have changed for most docs.  There are a few adventurous souls pursuing Direct Primary Care, getting by with minimal staff, and loving it. Of course, they are seeing far fewer patients. It’s OK. It works for them.

For the rest of us, we benefit a lot from the support.  And we can afford it, if we use our team effectively.

How Does a Team Win?

A team wins when everyone:

  • Knows which game they are playing
  • Understands their position on the team
  • Has practiced and can execute all the plays and
  • Can adapt quickly to changing conditions.

It’s not too different from any team sport. BUT IT IS A TEAM SPORT! We can’t play alone anymore, thinking that as the physician it’s our job to:

  • hike the ball,
  • block,
  • drop back to pass, and then
  • catch the ball downfield.

It’s impossible. (If you don’t like football, that’s OK. Pick any team sport and you can use the same analogy!)

What about Team Care in Health Care?

In team care in a physician’s office, everyone has their position and knows what they are supposed to do in each play.

  • The call center staff plan the appointments with protocols and ensure all billing info is collected before the patient is scheduled.
  • A nurse reviews the schedule and charts a day ahead to ensure any care gaps are identified and prepped.
  • The receptionist greets the patient and gets the visit process started according to in office protocols specific for each visit type.
  • Medical assistants “room the patient” and ensure any information the doctor needs is available before the doctor enters the room
  • The physician is called to the room when the patient is fully prepared, so as not waste time in the exam room on things other than giving full attention to the patient.
  • The medical assistant stays in the room with the physician and the patient, acting as a scribe to minimize keyboarding for physicians.
  • The physician reviews and approves the note and pended orders before leaving the room.
  • The medical assistant stays with the patient, ensuring all questions are answered and appointments scheduled.
  • Between patient encounters, the physician sits with their support staff to answer questions and keep the in-basket messages to a minimum.

It takes Practice, Practice, Practice

You may look at the list above and think it looks like a lot, maybe it’s too hard to get all this going. Like anything new, getting started isn’t easy. But considering the alternative is continuing to suffer with what you’ve got, and likely getting worse, the effort is worth the pain.

If you’re going to win with team care, you have to commit to the process. You and your teammates will make mistakes as you practice new ways to work together. That’s OK, as long as you learn from each mistake and stay committed to continuous improvement.

How will you know you’ve won?

As you stick with this, you get better. Pretty soon you are not going home exhausted at the end of the day with hours of keyboard time standing between you and your pillow. Your waiting room starts to look empty, but your productivity is increasing. Everyone on the team is smiling, even high-fiving at the end of a busy day. Your quality and patient satisfaction scores are going up. Your income is going up. You’re not missing so many significant events with family and friends.

If this sounds good to you, but you don’t know where to start, there are a lot of good resources available. Just ask me.  I’m happy to help.

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