Team Work

The NY Times recently wrote about pharmacists expanding roles on the health care team. This is one example of a concept who's time has come that has the potential to make a significant positive impact on health care outcomes. Conceptually, this makes sense since as we all know, health care doesn't just take place in hospitals or in private offices. Patients are constantly making choices about their health in their everyday actions such as choosing what and when to eat. Pharmacies are located in the communities where people live and work and having access to a health care coach or guide in the form of a pharmacist (or other professional) gives people the opportunity to discuss their options and perhaps make better every day health decisions.

Community health nurses have long known this as they visit patients in their homes and assess their living environment and offer recommendations that could eliminate safety hazards for partially paralyzed patients following a stroke for example. They have also spent countless hours teaching patients about their medications including how, when and where to take them. One of the biggest obstacles for home care nurses is the limited insurance coverage and restrictions that dictates how many visits a patient would receive (if any). Now the concept is taken to the next level by getting members of the health care team out into the community. This has been done for years by federally funded community health centers but now is gaining traction in the mainstream.

I believe the more access people have to health care providers, the better we can focus on disease management and wellness as long as patients are engaged in their own health. Perhaps constant reminders, visibility of providers and access could drive individuals to play a greater role in the provision of health care. However, the costs of this increased access remains unknown. Common sense would dictate that the greater access people have would increase utilization of services thus increasing costs. Maybe this is true under our current fee-for-service payment structure but we know that this structure is flawed. As new payment models are introduced that incentivize wellness, active patient engagement and a focus on evidence-based outcomes, we can finally move beyond the mindset that health care only takes place during a visit with a provider.

Finally, remember there is no "i" in team. A multidisciplinary approach is needed to have the right subject matter experts teaching, educating, treating and caring for patients. That means no "captain of the ship" or "ruler of the roost" - just a team of professionals partnering with patients to meet their health needs.