Physician Use of Health Care Teams for Improving Quality in Primary Care

Objectives: Health care teams may be used to improve quality in the primary care setting. Absent in the extant literature on health care teams is knowledge of how physicians seek to deploy this innovation on an everyday basis to improve care quality. This study's aim was to explore how physicians use teams in practice to deliver higher-quality care. Methods: A qualitative study using data collected through 39 interviews with primary care physicians and 9 interviews with medical assistants, employed across different primary care settings in the northeastern region of the United States. Results: Physicians used teams for 2 care quality functions: "getting basic care duties off their plate" to have more time for complex care delivery and "as relational extensions" of themselves to enhance the patient experience and provide care continuity. Physicians identified the following ingredients for using teams for these functions: (a) achieving long-term continuity working with the same team members; (b) having the correct mix of personalities and skills sets on the team; and (c) a "who is doing what" focus in the team for achieving role clarity. Conclusions: The findings illuminate how primary care physicians attempt to use teams to improve care quality and enhance their role as care providers.