Team Based Medicine

By Erin McAdams, MD

health-care-team-clipart-1   Picture compliments of

When you go to the doctor’s office, you might be fooled into thinking that your doctor is the person managing your healthcare. In some respects, you would be right. The person you are seeing in your appointment is in fact contributing to the management of your health concerns, be them acute or chronic, preventive or urgent health care. But in reality, it is not quite as straightforward as that (and I must admit, thankfully so). There are many “team members” that assist you in driving your medical care forward:  pharmacists, medical assistants, office staff, rehabilitation providers, counselors, and specialist providers, to name a few. Without this consortium of knowledge and skillsets, your care would quite simply suffer in every aspect imaginable.


With an upbringing largely dominated by participating in most sports that the Midwest offers, I have believed in the power of teammates and teamwork for the majority of my life. Surprisingly, I now realize that I overlooked the enormously inter-dependent nature of medicine until I started my residency program. Sure, as a medical student I interacted with different branches of health care. But as a resident physician, I have now been granted the privilege of making actual management decisions for patients. And I realize not only how much I have to learn about an endless list of topics, but also that doctors cannot, and should not, be trying to do absolutely everything for a patient without seeking help. Too many people are trained well in health care to allow patient care to be entirely managed by one physician.


The invaluable support and expertise of the team—the fluid group of therapists, older physicians, co-residents, nursing staff, chaplaincy, etc, all of whom dependably support patients—have made holistic, quality care attainable for many of the patients I have had the privilege of caring for, both in clinic and on the hospital wards. When I struggle with how to better care for my patients, the answer almost invariably is to involve more “team members”. My team has been there to teach me how to place orders in a new computer system, or show me the templates for hand-written notes (wait, what?!, isn’t this 2016?!). They have been there to support me in family meetings and help discuss end of life care with patient’s families. They have been present to direct my hands during procedures. The team has been there to help review labs on patients, guide management decisions, and stand in my place to relieve my exhausted arms during chest compressions during resuscitation efforts.


Team members can also provide words to name the feelings I have, particularly during emotionally and physically draining situations. As much fun as it is to finally “be a doctor”, the title comes with responsibility and a level of commitment not required in all professions. Many of my feelings are shared by others in the field of healthcare. My teammates feel a similar pressure to be better, to constantly improve. They understand the frustration with knowing what or how to treat a disease and improve health, yet being unable to provide that resource or medication to a patient because of a social situation or inadequate health care coverage. My teammates understand the struggle of providing personalized medicine and allowing patient autonomy, without foregoing evidence-based medicine or compromising personal conviction. Having people to validate your concerns, commiserate with your struggles, and celebrate with good patient care results is what makes team based medicine so indispensable. As I approach the end of my intern year, I look forward to a career’s worth of experience working with the many remarkable teammates I have already worked alongside, as well as those I will continue to learn from in the decades to come.


Full disclosure:  To demonstrate the strength of my belief in team-based medicine, this blog post was contributed to both by some words and inspiration of two other people, a fabulous co-intern and one sub-intern. Thanks, team.


Erin McAdams, MD is an Intern Family Medicine Resident in the Department of Family & Preventive Medicine at the University of Utah School of Medicine.


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