Is there a Doctor in the Team? The Use of Primary Care Teams

January 04, 2011

A recent article from U.S. News discussed the development of primary care teams, rather than individual doctors, for treating patients.

According to the story, "team" is a relatively new concept in family medicine. The writer tells of a colleague who told him, only half in jest, "My definition of good teamwork is that when I tell my office nurse to do something, he or she does it."

The concept is to examine the many elements of a visit to a doctor and change who does some of the information gathering and even some of the selection of treatments. Some medical practices are instituting systems where primary care teams delegate responsibilities so that each staff member does only what he or she is trained to do, rather than wasting time and energy of a doctor on more basic tasks that can be performed by those with less training.

This means screening tests and lifestyle counseling needs can be handled by nurses or aides, rather than solely by the doctor. This can have advantages for the patients, who can spend more time discussing their health issues with nurses or medical assistants than they might have with a time-strapped doctor.

In the best case scenario, the other members of the staff can prepare this information for the doctor, the doctor, when meeting with the patient, can focus on the actual medical questions the patient has, and better answer their concerns.

Better for Whom? Patients or the Bottom Line?

The unstated question behind all of this is whether it is used to spread doctors even more thinly among patients. Some practices see it as a way of improving the performance of doctors, by redirecting tasks appropriate for the training of other members of the staff. For some, the incentive will be increase the volume of traffic through the office.

With the new health care law creating an increased demand for primary care doctors, the existing shortage of some doctors could become worse. In states like California and Massachusetts, where universal health care has been put in place, the article reports there has already been severe shortages of pediatricians, family physicians and obstetrician-gynecologists.

If the system allows doctors to be more efficient, it is all well and good, but one can easily imagine in a world controlled by large insurance companies where doctors are required to see ever-higher numbers of patients.

Just as patients' bodies, when under stress, are more likely to be subject to illness, so to, a medical practice stretched to its limits, mistakes become more likely. Unfortunately, mistakes mean patients health and potentially their lives.

It is easy to speak of "efficiency" as if it were synonymous with "better." Nevertheless, efficiency always has a price. When it comes to health care, that price is often paid by the patient. And, potentially, the doctor's malpractice insurance.

While team doctoring has potential to increase efficiency for the medical practice, the same concerns for patients remain. Increased handoffs and less time with the doctor may not mean patients are receiving a lower level of care, but patients need to be ever vigilant.

If you believe some treatment seems inappropriate, or you suffer injuries as a result a visit to your doctor, you may want to discuss the matter with an attorney, who can help assess the situation and determine if the facts describe a viable malpractice case.

Article provided by Novak, Robenalt & Pavlik, L.L.P
Visit us at www.nrplaw.com