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Primary Care Physicians Worry about the Logistics of Team-Based Care

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Medical Economics recently compiled a list of the “Top 10 challenges facing physicians in 2016.” So far, these challenges have involved ever-changing payment models, the 2016 elections and healthcare reform, chronic care management, payer consolidation, the decision to remain independent or seek employment, the challenges related to MOC, Meaningful Use Stage 2 attestation, and remote medicine.

In our last post, we began looking at the challenges surrounding team-based care and how this is affecting physicians, even those who embrace the concept in theory.

There are also those physicians who do not embrace the idea of team-based care.

“According to a survey of primary-care providers conducted by the Kaiser Family Foundation and The Commonwealth Fund earlier this year, nurse practitioners (NPs) and physician assistants (PAs) are overwhelmingly positive about the emergence of models based on team care, but more than 4 in 10 primary-care physicians said ‘this shift is negatively affecting providers’ ability to provide quality care,’” Medical Economics reports.

Let’s be clear here: the primary-care physicians who object to team-based care have very legitimate concerns, namely how they’re supposed to bring staffers together who don’t have the same level of training, don’t have the same degree of medical knowledge, and don’t have the same understanding of the goals of care. It’s not that team-based care can’t be achieved, of course. Rather, it’s the incredible expenditure of time, resources, and money that’s required to establish team-based care.

The article puts it this way: “The real challenge for physicians is finding ways to integrate staff members with varying levels of training and unique strengths and weaknesses into a unified team with common goals, a detailed workflow, and clear treatment responsibilities that follow clinical guidelines for when and how providers must consult with physicians for patient care.”

Furthermore, not every practice is presently equipped to achieve team-based care. Robert Wergin, MD, FAAFP, a family physician based in Milford, Neb., who also serves as board chairman for the American Academy of Family Physicians (AAFP), told Medical Economics there are “three characteristics a practice must have to succeed at team-based care: flexibility to change and adapt when necessary, a staff champion who can lead and motivate the effort, and a trusting and open environment where providers focus solely on the best interests of patients, and are comfortable with their role on the team.”

“Team-based care is about designing roles, and identifying the strengths and weaknesses of your staff members,” Wergin explained. “We are all responsible for the best care possible for the patient.”

As physicians who are looking for jobs, what are your personal feelings about team-based care? Are you among the 40 percent of physicians who feel that this approach to care is “negatively affecting providers’ ability to provide care”? Would you turn down a job offer from a group, practice, or hospital that employed team-based care?

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