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The Teamlet Model of Primary Care

Department of Family and Community Medicine, University of California, San Francisco, Calif

CORRESPONDING AUTHOR: Thomas Bodenheimer, MD, Department of Family and Community Medicine, University of California, San Francisco, Bldg 80-83, San Francisco General Hospital 995 Potrero Ave, San Francisco, CA 94110, TBodenheimer{at}fcm.ucsf.edu

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ABSTRACT

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.

Key Words: Primary health care • delivery of health care • health care team • organizational innovation

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