Wednesday, September 17, 2014
Inquirer Daily News

How is Health Care Like Baseball? Teamwork Matters

Remember Marcus Welby, M.D.?

How is Health Care Like Baseball? Teamwork Matters

Remember Marcus Welby, M.D.?

If you don’t, it’s not surprising. We’ve come a long way from doctors hanging out a shingle and practicing with just one nurse and a receptionist. Back in the days of black and white TV, the doctor did everything, from weighing you to writing down the symptoms (with a pen, not on a computer) and handing you a prescription.

Things have certainly changed. According to the American Medical Association (AMA), fewer than 18 percent practiced on their own in 2013, and even doctors in small practices have nurses, medical assistants, a receptionist and billing people—and that’s the simple setting. In a hospital or skilled nursing facility you’re likely to meet nurse practitioners, aides, dietitians, physical therapists and social workers even before seeing the doctor. Often, the nurse practitioner, not the doctor, will do the first intake.

And all too often, it feels like a mess. One of my professional colleagues was the contact person for an elderly grandmother with dementia. She would get calls from different people about moving her between facilities—one would say that it was time to move her grandmother; another would call and say she had been moved to the wrong place. It hardly felt to her like a team focused on patient care, never mind a team playing by the same set of rules with the same objectives.

But that is starting to change. Health systems are increasingly focusing squarely on the issue of team medicine—sometimes calling it inter-professional collaboration. In part, this is motivated by cost—the old days of the doctors doing everything meant that too much of the doctor’s time was spent on things that others could do at lower cost, and too little on the highly skilled work a doctor is trained to do. But the emergence of team-based care is evidence that how care is delivered is becoming as important as what care is delivered.

In our management consulting practice, we see this in medical homes, (as described by Elizabeth Williams in her May 27 Field Clinic post), but we also see it within the specialist’s office and even the operating room. When my own son was considering major spinal surgery, our family spent many hours with the surgeon’s physician assistant working through the choices on everything from sources of blood to risk factors to recovery exercises. We could—and did—ask the surgeon questions, but the PA was accessible as things surfaced over time, and that “on the spot” quality made us all a lot less anxious. It also enabled us to make smarter choices.

How can you tell if your hospital, nursing facility, clinic or doctors’ office has teams that really work together, rather than a group of professionals acting independently? Here are some things we look for in our work with healthcare organizations, that you can ask in your own experience with your healthcare providers:

  1. Do the healthcare professionals know and show respect for each other?
  2. Do their roles seem clear—to them and to you?
  3. Are they sending you different messages, or are you hearing the same thing from each team member?
  4. Do they seem more focused on you than each other?
  5. Does your team care give you ample opportunities to understand your health problems and discuss choices about treatment?
  6. The bottom line is—are the different professionals actually coordinating your care so you don’t have to?

The good news is that true medical teamwork is spreading. Medical colleges, nursing schools, and schools of allied health across the country are starting to train students together so they learn from the start to be part of a team, not independent agents. Teamwork means better care and better health. The ultimate winner is you.

_________________________________

Lynn Oppenheim, Ph.D, MBA is President of CFAR, a consulting firm that helps organizations turn strategy into action.

-----

Have a health care question or frustration? Share your story »

Read more of The Field Clinic »
About this blog

The Field Clinic reports and analyzes health care laws, government policies, and political trends that are transforming the care we receive and the way we pay for it. Read more about our panel of bloggers here.

This blog is produced in partnership with Kaiser Health News, an editorially independent program of the Henry J. Kaiser Family Foundation, a nonprofit, nonpartisan health-policy research and communication organization not affiliated with Kaiser Permanente. Portions of this blog may also be found on Inquirer.com and in the Inquirer's Sunday Health Section.

Follow the Field Clinic on Twitter.

RSS feed.

Robert I. Field, Ph.D., J.D., M.P.H. Professor, School of Law & Drexel School of Public Health
Jeffrey Brenner, MD Founder of the Camden Coalition of Healthcare Providers, Medical Director of the Urban Health Institute at Cooper University Healthcare
Andy Carter President & CEO, The Hospital & Healthsystem Assoc. of Pa.
Robert B. Doherty Senior Vice President of Governmental Affairs & Public Policy American College of Physicians
David Grande, MD, MPA Assistant Professor of Medicine at the University of Pennsylvania
Tine Hansen-Turton Chief Strategy Officer of Public Health Management Corporation
Drew A. Harris, DPM, MPH Director of Health Policy Program at the Jefferson School of Population Health
Antoinette Kraus Director of the Pennsylvania Health Access Network
Laval Miller-Wilson Executive Director of the Pennsylvania Health Law Project
David B. Nash, MD, MBA Founding Dean of the Jefferson School of Population Health
Mark V. Pauly, Ph.D. Professor of Health Care Management, Business Economics and Public Policy at The Wharton School
Howard J. Peterson, MHA Managing Partner of TRG Healthcare, a national healthcare consulting firm
Donald Schwarz, MD, MPH Deputy Mayor for Health & Opportunity and Health Commissioner for the City of Philadelphia
Paula L. Stillman, MD, MBA Healthcare consultant with special expertise in population health and disease management
Elizabeth A. W. Williams Senior Vice President & Chief Communications Officer for Independence Blue Cross
Krystyna Dereszowska A third-year law student concentrating in health at Drexel
Latest Health Videos
Also on Philly.com:
Stay Connected