What kind of work?? TEAMWORK!!

For those of you with young children, you may recognize the title as a catchy (sometimes so catchy that one can't get it out of their head) theme song for Nick Jr.'s Wonderpets.  Every time I hear the song (and I hear it frequently) I cannot help but think of Karen Nichols, DO's (current President of the American Osteopathic Association) them for this year of TEAMWORK.

Teamwork is essential to the delivery of quality medical care.  Given this, teaching and mentoring teamwork is also essential for OGME.

I played on Juniata College's baseball team many years ago (glory days alert).    Baseball has 9 players on the field at a given time and a successful team has many pitchers and non-starters that contribute.  My college baseball team had arguably (I may be biased) the most successful three year stretch in the schools history.  There was only one player on those TEAMs who I would label a star (and it wasn't me).  We were successful because we were a cohesive team.

Medical care is much the same.  High quality care in the 21st Century is delivered best by a health care team.  These teams are not one-size-fits all.  Physicians need to be members of these teams, but may not lead every aspect of these teams...but...physicians need to be leaders.

To be leaders, physicians need to understand team dynamics.  To be leaders, physicians need to understand the perspectives of other members of the team (advanced practitioners, nurses, care managers, physical therapists, social workers, etc.).  To be leaders, physicians need to be able to effectively communicate.

So, do we teach all of this in our OGME programs?

The honest answer in my view has to be:  No, not very well...yet.  At the yet is the takeaway from this post.

A recent monograph from the Josiah Macy Foundation on Intraprofessional Education give a good road map of how to achieve yet.  The topic of teamwork was also the foundation of the recent AODME/AACOM meeting in Baltimore.

Our current Basic Standards for residency training do not promote teamwork and intraprofessional training as much as they should, but they also do no inhibit programs from innovating.  The former needs to be bolstered.

It should not be possible for future residents to graduate from our programs without having both training and experience with working in health care teams.  They should also have explicit opportunities to lead health care teams.  We also need to look for opportunities to leverage intraprofessional relationships that exist within some of our Colleges of Osteopathic Medicine to learn side-by-side with other professionals.

My personal sentinel model of health care was a brilliant team.  It was a "womb to tomb" primary care physician and his wife.  Together they were doctor, nurse, pharmacist, counselor, receptionist, secretary and office assistant.  Other than the first two roles they shared almost everything else.  That TEAMWORK provided excellent medical care for 40+ years.  That team was my grandparents.  Our patients need more relationships like this.

TEAMWORK needs to be one focus for OGME in the future.  TEAMWORK requires both give and take - and this will likely be one large challenge as we move forward, but our patients will demand the quality of care that only TEAMWORK can provide.