Physician-Led, Team-Based Care Priority for Physicians

When patients are sick and need care, they trust their physicians and their team of health care professionals. “The team” not only includes the physician, but other vital health care providers such as physician assistants (PAs) and certified registered nurse professionals (CRNPs).

“We work as a team, said Michael McGarey, MD, a neurologist practicing in Philadelphia. “I rely on them to do what they are experts at doing, and they rely on me to do what only a physician can do.”

But, right now, Pennsylvanians have a good reason to be concerned about the future of their health care as the changing health care marketplace drives changes in the roles of physicians and other providers within the medical practice. They see changes everywhere they turn, and worry that:

  • They won’t be able to keep their relationship with their trusted physician
  • Access to care will be harder as demand increases
  • Their communities won’t be able to keep the young physicians they need because massive medical school debt drives them elsewhere.
Strong teams are multi-professional; collaborate with each other, the patient, and the patient’s family; and share a common goal — to achieve coordinated, high quality, patient-centered care. In a strong health care team, all team members perform to the full extent of their training and skills; share data, patient records, and other information about the patient’s care and treatment on a regular basis’ and use protocols and physician consultations to avoid unnecessary tests or referrals.

Pennsylvanians look to their physicians to lead in times of change and transition. They also look to their legislators to make the right decisions to protect the future efficiency, safety, and quality of their health care. Urge Pennsylvania legislators to enact measures that support team-based care.

With millions more Pennsylvanians gaining health insurance as the ACA goes into effect, the Pennsylvania Medical Society (PAMED) wants to be sure that care is physician-led and team-based.

Two new laws (Act 100 for MDs and Act 101 for DOs), which went into effect Jan. 26, 2014, allow a physician the option of relaxing current physician assistant (PA) countersignature requirements. The passage of these bills is a great example of how physician-led, team-based health care can be streamlined, increasing productivity and access to care, while at the same time preserving patient safety.

As a long-time proponent of patient-centered, team-based care, PAMED strongly supports two bills that propose a Patient-Centered Medical Home Advisory Council. These proposals, introduced by Sen. Judy Schwank (D-Berks) and Rep. Matt Baker (R-Tioga), provide unique opportunities for Pennsylvania to build a stronger framework for our health care teams, which will in turn help nurture the development of patient-centered care.

“We’re very concerned that we need to strengthen, not abandon, the health care team,” said Bruce MacLeod, MD, president of PAMED. “Our policymakers face a crossroads right now, and it’s important that they get the facts.”

Fact: 76 percent of patients said that they prefer a physician to lead and coordinate their own and their family’s health care.

Fact: The skills of physicians and other providers, such as nurse practitioners, physician assistants, and pharmacists are complementary. Studies have proven that when they work effectively together, care improves.

“It comes down to feeling comfortable and confident within the scope of practice and looking to see how they work together for the benefit of our patients,” said Melissa Brown, MD, a former RN. “I don’t think it’s so much changing nursing practice — it’s about working together.”

PAMED applauds Gov. Tom Corbett’s Healthy PA plan because it supports and encourages strong health care teams as a key to protecting health care quality, efficiency, and safety. We are working with the governor to enact critical elements of this plan, including preventing fragmentation of the health care team, improving access to care for the uninsured and underserved, and retaining and recruiting the physician workforce, especially student debt forgiveness and expanded residency slots.

Additional Resources

  • CME: Improving Patient Outcomes Via Team-Based Care
  • CME: Maximizing Patient Care: Making the Most of Your Health Care Team
  • More on team-based care