Skip to main content

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.

Comments

Home Energy said…
As team pork always works. Hence while doing any work we must work well with our team work.

Popular posts from this blog

Private Practice

There is an interesting trend that I'm observing and don't necessarily see how this is going to turn out. I'm seeing more and more nurse practitioner's opening their own autonomous practices. Many of these offices set out to offer care that is personalized, covered under insurance, and of course high-quality. I'm also seeing more NP specialty/sub-specialty practices such as house calls, incontinence, and women's health. This is in a time when more physician practices are joining together in these conglomerations that aren't necessarily tied to hospitals. You'd be hard pressed to find a solo primary care physician these days yet nurse practitioner solo practices are popping up. The talk about the formation of accountable care organizations can be attributed to health care reform and the spurring of large multi-physician practices. What to make of this? I honestly don't know. Many people and patients have said to me "you should start your own prac

NP Residency

The healthcare system of today is so complex yet so dysfunctional that I believe the time has come to educate and train the NP providers of tomorrow in a way that is reflective of that complexity. We have done a good job up to this point but need to bring that to the next level. Residency. I'm not necessarily referring to the typical residency training of physicians which takes place in hospitals but a residency-type of program in an out-patient setting (ironic that we use the term residency). We realize that healthcare is not exclusively delivered in hospitals. It takes place in independent providers offices, in community health centers, in mobile health vans, and in retail settings. It takes place in people's homes and places of employment. It takes place in many of the health decisions that we make on a daily basis. I found this NP residency program in Connecticut that claims to be the first NP residency in the US. The programs admits 4 NPs each year and trains them to ha

Repost: Let Us Be Heard

I started this blog, A Nurse Practitioner’s View, 3 years ago because there were very few health stories that even mentioned nurse practitioners as part of the health care landscape. Right before I started the blog, I would respond to other health policy articles published on the Web by writing comments to the websites – only to be subjected to baseless and factually incorrect statements. It was soon thereafter that I decided I would write my own perspective on health policy, trends, and news. I also felt it important from a credibility aspect to not blog anonymously but to put my name on it. I recall those few early blog posts that I proudly wrote and would feverishly check my blog visitor stats to see if people were reading. Well, it was a bit slow going in the beginning with about 10 – 15 readers but as they say, “if you build it, they will come.” Today, the blog enjoys hundreds of visits a day, has a Facebook following, has enabled me to be “discovered” to blog at  Online Nurse