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Team approach to health care means new role for doctors

Sophie Quinton, Stateline.org on

Published in Health & Fitness

In a statement, the association said it "encourages physician-led health care teams that utilize the unique knowledge and valuable contributions of all clinicians to enhance patient outcomes." It noted that top hospital systems are using physician-led teams to improve patients' health while reducing costs.

To be sure, doctors won't be displaced anytime soon. But shifting tasks to other professionals may reduce the need to train so many of them.

According to a 2013 study by the nonpartisan Rand Corporation, there are about seven doctors per 10,000 patients under a standard primary care team model. But under models that include more nurse practitioners and physician assistants, just six doctors are needed. And in clinics run by highly trained nurses, the ratio drops to less than one doctor per 10,000 patients.

Hospital systems like UCHealth, the University of Colorado-affiliated system where Lin and Peterson work, are betting that the future of health care involves a mix of professionals sharing responsibility for patients. Doctors will still run the show, but they'll have to give up some control.

That culture change makes many doctors uneasy at first. Doctors want to protect their one-on-one relationship with patients. They may not understand what their non-physician colleagues have been trained to do, or are legally able to do. And many worry that change will make them even busier, by forcing them to manage the lower-credentialed professionals around them.

Lin is the chief information officer for UCHealth. As an administrator, he's always pushing for change -- his latest project is a system that releases certain test results to patients the moment they become available. But as a practicing doctor, he also understands that change is hard.

Having Peterson in the examination room with him took some getting used to, he said. "Like many doctors, I have a fear of letting go of all the things I traditionally do." That includes documenting a visit. "I'm getting over it, because I don't want to be the only one here at 8 o'clock at night, typing."

Matt Moles, a doctor who practices in the same clinic, said he also initially felt uncomfortable. Sharing the examination room went against his medical training, he said: "We're trained to trust no one."

It's still possible for doctors to have jobs that resemble the Norman Rockwell era of long consultations, if they're willing to opt out of the mainstream. A small but growing number are setting up or joining practices that, rather than taking health insurance, charge patients a monthly fee, typically around $75, for unlimited visits.

"I personally have the mentality of -- leave me alone, I'll take care of my patients," said Dr. Cory Carroll, when reached by phone at his family care practice in Fort Collins, Colo. He's been a solo practitioner for most of his 25-year career.

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