The Teamlet Model of Primary Care

The 15-minute visit does not allow the physician sufficient time to provide the variety of services expected of primary care. A teamlet (little team) model of care is proposed to extend the 15-minute physician visit. The teamlet consists of 1 clinician and 2 health coaches. A clinical encounter includes 4 parts: a previsit by the coach, a visit by the clinician together with the coach, a postvisit by the coach, and between-visit care by the coach. Medical assistants or other practice personnel would require retraining to assume the health coach role. Some organizations have instituted aspects of the teamlet model. Primary care practices interested in trying out the teamlet concept need to train 2 health coaches for each full-time equivalent clinician to ensure smooth patient flow.

[1]  Judith A. Hall,et al.  Studies of doctor-patient interaction. , 1989, Annual review of public health.

[2]  M K Marvel,et al.  Soliciting the patient's agenda: have we improved? , 1999, JAMA.

[3]  F. Federico,et al.  Preventing medication errors. , 2000, International journal for quality in health care : journal of the International Society for Quality in Health Care.

[4]  M O Roland,et al.  Identifying predictors of high quality care in English general practice: observational study , 2001, BMJ : British Medical Journal.

[5]  S. Childs,et al.  The relationship between consultation length, process and outcomes in general practice: a systematic review. , 2002, The British journal of general practice : the journal of the Royal College of General Practitioners.

[6]  Katrina M. Krause,et al.  Primary care: is there enough time for prevention? , 2003, American journal of public health.

[7]  E. McGlynn,et al.  The quality of health care delivered to adults in the United States. , 2003, The New England journal of medicine.

[8]  D. Schillinger,et al.  Closing the loop: physician communication with diabetic patients who have low health literacy. , 2003, Archives of internal medicine.

[9]  G. Bazzoli,et al.  Leadership Changes Reinvigorate Cleveland's Health Care Market. Washington, DC: Center for Studying Health System Change , 2005 .

[10]  T. Bodenheimer Helping patients improve their health-related behaviors: what system changes do we need? , 2005, Disease management : DM.

[11]  F. Platt,et al.  What Else? Setting the Agenda for the Clinical Interview , 2005, Annals of Internal Medicine.

[12]  Katrina M. Krause,et al.  Is There Time for Management of Patients With Chronic Diseases in Primary Care? , 2005, The Annals of Family Medicine.

[13]  P. R. Minton Setting the agenda for the clinical interview. , 2006, Annals of internal medicine.

[14]  The expanding roles and occupational characteristics of medical assistants: overview of an emerging field in allied health. , 2006, Journal of allied health.

[15]  D. Schillinger,et al.  Behavior-change action plans in primary care: a feasibility study of clinicians. , 2006, Journal of the American Board of Family Medicine : JABFM.

[16]  Dean Schillinger,et al.  Using action plans to help primary care patients adopt healthy behaviors: a descriptive study. , 2006, Journal of the American Board of Family Medicine : JABFM.

[17]  H. Holman,et al.  Helping Patients Adopt Healthier Behaviors , 2007 .

[18]  Dylan M. Smith,et al.  The relative importance of physician communication, participatory decision making, and patient understanding in diabetes self-management , 2002, Journal of General Internal Medicine.

[19]  P. Aspden,et al.  Preventing Medication Errors , 2007 .