The Team Issue: Medical Post editorial

The whole orchestra: overcoming barriers to team-based care

“Everyone talks about team-based care—politicians, doctors, the CMA, etc.,” wrote my friend Dr. Eric Cadesky, a Vancouver FP, but, he points out, these barriers remain:

1. There is not a lot of funding for it.
2. There is not a lot of infrastructure for it.
3. Where there is funding and infrastructure, there is not a lot of physician autonomy.

Indeed, at the primary care level, the College of Family Physicians of Canada has been pushing the Patient’s Medical Home (PMH) model for what seems like forever, but the OurCare report suggests only about 25% of patients in Canada have access to team-based care.?

Of course teams exist everywhere healthcare workers are, whether formally mandated or not. Doctors make great team leaders but leadership is a funny thing—you have to restate things more than seems natural. “I believe in regular in-person meetings with staff,” Dr. Ben Barankin, a dermatologist on the Medical Post’s advisory board wrote to me when I asked about teams. “We do send out informational emails between meetings, but it’s never clear who has read them, understood them or will remember them. When there is active in-person dialogue, we’re able to really flush things out including the finer details, and people feel heard. We also try to adopt any good suggestions promptly to show that we not only listen and care, but will actively implement good ideas. We also periodically reward staff with gift cards for their great ideas.”

Shoutouts

Part of the awesomeness of doctors is that they are independent thinkers. But as one of the great members of our team of journalists, Louise Leger, writes in her article on page 14, that autonomy means “team” doesn’t always come naturally to some clinicians. Yes, allied healthcare providers often don’t do things the way that doctors would, but, in some situations physicians need to accept that that is OK.

Also in this issue, another awesome member of our Medical Post team, Kylie Taggart, organized a great debate between a pharmacist and a doctor about pain points in the prescribing relationship (page 25).?

Retired physician Dr. Mike Goodwin of Niagara Falls, Ont., mentioned this great quote by the late Halford Luccock, an American Methodist minister that really captures it: “No one can whistle a symphony. It takes a whole orchestra to play it.”

And as Dr. Cadesky says, we need the funding and the infrastructure to do it.?