Experts Share Winning Strategies for Care Team Management
With workforce shortages impacting health systems and hospitals across the country, the effective formation and management of care teams is more important than ever.
The physician shortage in many specialties is particularly challenging for care teams. Health systems and hospitals have risen to this challenge by employing more advanced practice providers (APPs) to maintain care access and lighten the load on physicians.
In recent conversations with HealthLeaders, a pair of CMOs gave different takes on whether care teams should always be led by physicians or whether it is appropriate for care teams to be led by APPs or nurses in some circumstances.
Jill Kalman, MD, CMO of Northwell Health, says physician-led collaborative care teams deliver the best patient outcomes.
“Multidisciplinary care teams should be collaborative, with flexibility to adapt based on the patient’s needs and setting,” Kalman says. “Whether in the hospital or outpatient clinic, well-structured teams ensure the best outcomes.”
While the growing role of APPs helps address physician shortages, physician-led teams provide the optimal structure for delivering high-quality, patient-centered care, according to Kalman.
In a well-designed care model at Northwell, different team members contribute their expertise, with physicians providing oversight and team decision-making for complex cases. Kalman highlights the importance of flexibility.
“An advanced practice provider may manage a patient’s diabetes and hypertension, but if that patient presents with rapid atrial fibrillation and a fever, physician consultation is essential to determine next steps,” Kalman says.
Physicians, APPs, nurses, pharmacists, respiratory therapists, and other healthcare professionals all play key roles in guiding a patient through their care at Northwell, with physicians providing clinical oversight, Kalman says.
APPs such as nurse practitioners and physician assistants are going to play leading roles on care teams more often, according to Suzanne Wenderoth, executive vice president and CMO of Tower Health as well as a HealthLeaders CMO Exchange member. Historically, CMOs and other healthcare leaders have thought that physicians should lead care teams under all circumstances, but that view is changing.
“Now, we recognize with both changes to laws in the states, which allow for full practice authority for advanced practice providers, and the physician shortage in the post-COVID era, there has been an evolution in our thinking,” Wenderoth says.
At Tower Health, APPs and nurses are under consideration for leadership roles on care teams, Wenderoth explains.
“At Tower Health, we do believe that every care team should have access to a physician,” Wenderoth says. “But whether care teams need to be led by a physician is up for discussion.”
There are circumstances where a care team can be led by an APP or a nurse, according to Wenderoth.
Christopher Cheney is the CMO editor at HealthLeaders.