See a team when you head to the doctor

By Jodi Mohrmann - Managing Editor of special projects
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Experts say an increasing number of practices are adopting a team-based model of medicine.  A group of medical professionals divide up responsibilities and that frees up the supervising physician.

"The idea here is that I don't have to do the entire job myself. I have ten employees that work for me and we all have a different view of how to take care of a patient," said David Novelli, MD, a team-based care physician with Catholic Medical Partners in New York.

A team might include a nurse practitioner, a physician assistant, a medical assistant, a care coordinator, a nurse and office manager.  Some groups may even have a dietician or clinical pharmacist.  Each team member has a unique role and skill set, which experts say is good for patients.

"They benefit from having these different styles, these different training, different levels of expertise," explained Novelli.

Both the American Medical Association and the American College of Physicians have put their support behind team based models. 

"We think ahead of the visit so that when the patient is coming in for an appointment we've already met to figure out what does this patient need," said Yul Ejnes, MD with the American College of Physicians.

Experts say good team work is necessary for this model to work.

"The interaction between members of the team is very important. They respect each other, they work well together, and if you have that, you have great patient care," said Novelli.

Of course there may be times when a patient may prefer to see their physician to deal with a more complicated problem, or just because they feel more comfortable. Doctors say they work to accommodate patients' wishes. 

"That may come at, at a cost in terms of timing.  Because the nurse practitioner, for example, might be able to see you today and I might not be able to see you until tomorrow.  But, if the patient is given the option then they can make the choice that works best for them," explained Ejnes.

But doctors say most patients are happy to have the extra attention from the other team members.   

"I've had patients leave the room with me and spend an extra 20 minutes with the nurse care manager going over their diet. So the patients are getting more attention in terms of taking care of the problems that they're struggling with," Ejnes added.

The American Medical Association says that team-based models can also help physicians meet the new surge in demand for medical care that has come with millions of new Americans now insured through the Affordable Care Act. In terms of costs to patients, Enjes says, typically, the co-pay is the same no matter which team member a patient sees.  

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