The Article in Brief

The Teamlet Model of Primary Care

Thomas Bodenheimer, MD , and colleagues

Background The 15-minute doctor visit must be eliminated as the standard in primary care, according to this essay. The authors propose that it be replaced by a teamlet (little team) model, which has 2 main features: (1) the patient visit involves 2 caregivers--a clinician (doctor, nurse-practitioner, or physician’s assistant) and a health coach--rather than only the clinician; and (2) the 15-minute visit is expanded to include 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. According to the authors, the teamlet model is a blueprint for addressing some of the serious problems facing primary care: inadequate visit time to provide all recommended acute, chronic, and preventive care; doctor and patient dissatisfaction with the rushed atmosphere of many visits; and inadequate quality of care that may be provided by stressed primary care practices. Pilot projects are underway to test whether this model of care is practical.