[ Back to EurekAlert! ] Public release date: 16-Sep-2013
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Contact: Angela Collom
American College of Physicians

Internists offer principles for organizing clinical care teams in policy paper

American College of Physicians committed to meeting needs of patients through team-based model of care

Philadelphia, September 17, 2013 -- The American College of Physicians (ACP) sets the framework for a team-based model of health care in a new policy paper published today in the peer-reviewed medical journal, Annals of Internal Medicine. ACP offers more than a dozen principles to encourage and enable clinicians to work together effectively in dynamic clinical care teams. The policy paper, Principles Supporting Dynamic Clinical Care Teams, outlines a process for creating more nimble, adaptable partnerships that encourage teamwork, collaboration, and smooth transitions of responsibility to ensure the needs of patients are met at each step of the way.

"We hope to encourage positive dialogue among all health care professions to advance team-based and collaborative models that are organized for the benefit and best interests of patients," said Molly Cooke, MD, FACP, president of ACP. "In addition, regulatory and payment polices must be aligned with, and support team-based care models rather than creating barriers."

While reaffirming its support of the Joint Principles of the Patient-Centered Medical Home in the paper, ACP said it recognizes that the current model of health care delivery will need to change to meet the coming demand of patients.

"Internists are particularly well-qualified to care for adults with complex illnesses and diagnostic challenges," Dr. Cooke said. "Depending on their specific clinical needs and circumstances, however, patients might appropriately be seen by other members of the clinical care team with physicians being available for referral or consultation as needed."

Highly-functioning teams typically assign responsibility and authority for distinct organizational domains to the person or persons most appropriate for the tasks required, the paper says. Clinical care teams will vary in their composition depending on the medical specialty (e.g., internal medicine or cardiology), the clinical setting (inpatient, outpatient, small practice, large institution) and will vary in their function depending on leadership, institutional policies, available team members, even individual talents and characteristics of specific team members. Optimal effectiveness of clinical care teams requires a culture of trust, shared goals, effective communication, and mutual respect for the distinctive skills, contributions, and roles of each team member.

"These principles offer a framework for an evolving, updated approach to health care delivery, providing policy guidance that can be useful to clinical teams themselves in organizing their care processes and clinician responsibilities consistent with professionalism," Dr. Cooke pointed out.

The paper's principles cover four categories -- professionalism, licensure, reimbursement, and research and include:


The American College of Physicians is the largest medical specialty organization and the second-largest physician group in the United States. ACP members include 137,000 internal medicine physicians (internists), related subspecialists, and medical students. Internal medicine physicians are specialists who apply scientific knowledge and clinical expertise to the diagnosis, treatment, and compassionate care of adults across the spectrum from health to complex illness. Follow ACP on Twitter and Facebook.

Annals of Internal Medicine is one of the most widely cited peer-reviewed medical journals in the world, with a current impact factor of 13.9. The journal has been published for 86 years. It accepts only 7 percent of the original research studies submitted for publication. Follow Annals on Twitter and Facebook.

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