ORLANDO, Fla. — As a patient’s care now often lies in the hands of many collaborating health care professionals, the American Medical Association (AMA) today adopted ethical guidance for physicians as leader-members of care teams. Team-based health care models have emerged as the preferred method for providing coordinated, cost-effective and high-quality health care for patients.

Health care teams involve physicians, nurses, social workers and other health care professionals — all of whom play various clinical and administrative roles in the care of a single patient — at one or several sites of care. By virtue of their thorough and diverse training, experience and knowledge, physicians have a distinct appreciation of the breadth of health issues and treatment options that enable them to integrate the diverse professional perspectives and recommendations of the team into an appropriate, coherent plan of care for the patient.

“Physician-led collaborative care has been proven time and again as an effective, consultative approach to providing high-quality medical care,” said AMA Board Member Kevin W. Williams. “An effective team requires vision and direction of an effective leader and physicians are uniquely suited to serve as a clinical leader who will ensure that the team as a whole functions effectively and facilitates patient-centered decision-making.”

As leaders within health care teams, physicians individually should:

• Model leadership by:

• understanding the range of their own and other team members' skills and expertise and roles in the patient's care;

(ii)     clearly articulating individual responsibilities and accountability;

(iii)    encouraging insights from other members and being open to adopting them; and

(iv)    mastering broad teamwork skills.

• Promote core team values of honesty, discipline, creativity, humility, and curiosity and commitment to continuous improvement.

• Help clarify expectations to support systematic, transparent decision making.

• Encourage open discussion of ethical and clinical concerns and foster a team culture in which each member’s opinion is heard and considered and team members share accountability for decisions and outcomes.

• Communicate appropriately with the patient and family and respect their unique relationship as members of the team.

As leaders within health care institutions, physicians individually and collectively should:

• Advocate for the resources and support health care teams need to collaborate effectively in providing high-quality care for the patients they serve, including education about the principles of effective teamwork and training to build teamwork skills.

Encourage their institutions to identify and constructively address barriers to effective collaboration.

• Promote the development and use of institutional policies and procedures, such as an institutional ethics committee or similar resource, to address constructively conflicts within teams that adversely affect patient care.

According to the AMA’s new ethical guidance, teams are defined by their dedication to providing patient-centered care, protecting the integrity of the patient-physician relationship, sharing mutual respect and trust, communicating effectively, sharing accountability and responsibility, and upholding common ethical values as team members.

The collaborative care guidance will be added to the AMA Code of Medical Ethics, which was modernized recently after an eight year project to ensure physicians have useful and effective ethical direction that keeps pace with emerging demands, new technologies, changing patient expectations and shifting health care priorities.