As care team leaders, physicians should set right tone

Kevin B. O'Reilly
Editor
AMA Wire
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The AMA has adopted new policy that lays out the ethical obligations that physicians have to lead and participate in the team-based care model that research shows can improve health care quality and patient outcomes, enhance care access and slow the rate of medical spending while reducing burnout among health professionals.

“Such teams are defined by their dedication to providing patient-centered care, protecting the integrity of the patient-physician relationship, sharing mutual respect and trust, communicating effectively, sharing accountability and responsibility, and upholding common ethical values as team members,” says an AMA Council on Ethical and Judicial Affairs report adopted by the House of Delegates at the 2016 Interim Meeting in Orlando, Fla.

Yet inadequate resources, staff turnover and team conflicts can impede the proper functioning of physician-led care teams, the CEJA report says.

That is why physician leadership is essential. According to the new AMA policy, doctors should act as model team leaders by:

  • Understanding the range of their own and other team members' skills and expertise and roles in the patient's care
  • Clearly articulating individual responsibilities and accountability
  • Encouraging insights from other members and being open to adopting them
  • Mastering broad teamwork skills

They should also promote core team values of honesty, discipline, creativity, humility, curiosity and commitment to continuous improvement; help clarify expectations to support systematic, transparent decision-making; and encourage open discussion of ethical and clinical concerns and foster a team culture in which each member’s opinion is heard and considered and team members share accountability for decisions and outcomes.

Physician team leaders should also communicate appropriately with the patient and family and respect their unique relationship as members of the team, says the CEJA report. Doctors also have a role as leaders within health care institutions, the new AMA policy says. In that organizational leadership role, physicians should:

  • Advocate for the resources and support health care teams need to collaborate effectively in providing high-quality care for the patients they serve, including education about the principles of effective teamwork and training to build teamwork skills
  • Encourage their institutions to identify and constructively address barriers to effective collaboration
  • Promote the development and use of institutional policies and procedures, such as an institutional ethics committee or similar resource, to constructively address conflicts within teams that adversely affect patient care

A collaborative approach to care has been shown to effectively provide high-quality care, AMA Board Member Kevin W. Williams said in a statement. “An effective team requires vision and direction of an effective leader, and physicians are uniquely suited to serve as a clinical leader who will ensure that the team as a whole functions effectively and facilitates patient-centered decision-making.”

Read more news coverage of the 2016 AMA Interim Meeting.

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Dec 11, 2017
To meet the 2017 reporting deadline, physicians must report on at least one patient and one measure by Dec. 31 and submit to Medicare no later than Feb. 28 to avoid a payment penalty in 2019.