Health care teams are composed of health professionals who work together to treat a patient. The makeup of a health care team may vary depending on country, practice and the health care system. In general, health care teams include medical staff, nursing staff, social services and other health professionals.
In a hospital, the medical staff is led by the attending physician, who diagnoses the patient's illness, decides on a method of treatment and takes responsibility for the patient's well-being. The attending physician may be assisted by resident physicians and medical students. The nursing staff plans the patient's care, administers medicines and treatments prescribed by the medical staff and provides the daily care necessary for the patient's comfort. The registered nurse may be assisted by nurse practitioners, clinical nurse specialists, licensed practical nurses and nursing students. Due to the accompanying stress of a medical condition, social services provide counseling and information. They may help the patient in planning for recuperation or further medical services such as home health care or extended-care facilities. They can also provide financial information. Other health professionals may include psychologists, respiratory therapists, physical therapists, dieticians, laboratory technicians and pharmacists.
The importance of teamwork and cooperation within a health care team has been emphasized by the National Health Service. One report issued by the service stated: "The best and most cost-effective outcomes for patients and clients are achieved when professionals work together, learn together, engage in clinical audit of outcomes together, and generate innovation to ensure progress in practice and service." In her article "Democracy, Performance and Outcomes in Interdisciplinary Health Care Teams," Stephanie J. Coopman emphasizes how essential health care teams have become. As technology advances and medical training becomes more sophisticated, disciplines within the medical field become more interdisciplinary. Specialists in numerous disciplines are required to work together to treat and diagnose patients. According to Coopman, "team-based health care organizations are considered more effective, efficient, and adaptive than bureaucratic, hierarchically structured ones." A team environment promotes creativity, proactive decision-making and camaraderie.
Unfortunately, these ideals are often difficult to accomplish due to various barriers among professionals. For the most part, general practitioners are mostly men while women dominate the rest of primary-care service. Other impediments involve perceived differences in status between doctors and nurses, the lack of an organized structure in management, different ideologies, a lack of information-sharing and role conflicts. Professionals that specialize in different disciplines often consider their field to be superior to other fields and may resist sharing ideas or being open-minded. Any nonmedical input, perhaps offered by a social worker, may be deemed irrelevant by a physician. Physicians often struggle for autonomy and will naturally take on the leadership role in an environment ideally set for equal decision-making. Different personality traits can also result in team conflicts. Insecurities regarding confrontation can stretch out a conflict. A risk-taker in a group of more conservative members can stir controversy. A group of experienced physicians may not be inclined to respect the opinion of a recently trained physician.
According to Philip G. Clark, author of Health Care Teamwork: Interdisciplinary Practice and Teaching, professional autonomy and the fear of making mistakes can cause serious conflict in a health care team. Clark notes, "The team must assure a common definition of a patient's problems and open communication between the disciplines to determine type and sequence of interventions." Team members must trust one another and give honest opinions. Members of a health care team will be pressured by time restraints, uncertainty and change. These factors can bring further conflict if a team member fails to solve a problem on the spot or does not admit to difficulties or mistakes. If health care professionals feel they lack the skills for working on a team, they do all they can to avoid difficulties or confrontation.
Various members of a health care team provide different information, thereby necessitating communication and information-sharing. Coopman says: "When just a few members have needed information, participation by all group members is crucial for effective decision making. When all group members have the same information, participation is less critical." Sharing information facilitates productive decision-making, promotes commitment to the team and increases satisfaction with the team as a whole and individual efforts. Coopman continues, "The hallmarks of small group democracy are (a) equity in speaking opportunities, (b) listening to others' perspectives, and (c) equal say in making decisions." Saving a life requires not only vast medical knowledge and experience, but also good communication skills and broadening the mind.