Skip to main content

Main menu

  • Home
  • Current Issue
  • Content
    • Current Issue
    • Early Access
    • Multimedia
    • Podcast
    • Collections
    • Past Issues
    • Articles by Subject
    • Articles by Type
    • Supplements
    • Plain Language Summaries
    • Calls for Papers
  • Info for
    • Authors
    • Reviewers
    • Job Seekers
    • Media
  • About
    • Annals of Family Medicine
    • Editorial Staff & Boards
    • Sponsoring Organizations
    • Copyrights & Permissions
    • Announcements
  • Engage
    • Engage
    • e-Letters (Comments)
    • Subscribe
    • Podcast
    • E-mail Alerts
    • Journal Club
    • RSS
    • Annals Forum (Archive)
  • Contact
    • Contact Us
  • Careers

User menu

  • My alerts

Search

  • Advanced search
Annals of Family Medicine
  • My alerts
Annals of Family Medicine

Advanced Search

  • Home
  • Current Issue
  • Content
    • Current Issue
    • Early Access
    • Multimedia
    • Podcast
    • Collections
    • Past Issues
    • Articles by Subject
    • Articles by Type
    • Supplements
    • Plain Language Summaries
    • Calls for Papers
  • Info for
    • Authors
    • Reviewers
    • Job Seekers
    • Media
  • About
    • Annals of Family Medicine
    • Editorial Staff & Boards
    • Sponsoring Organizations
    • Copyrights & Permissions
    • Announcements
  • Engage
    • Engage
    • e-Letters (Comments)
    • Subscribe
    • Podcast
    • E-mail Alerts
    • Journal Club
    • RSS
    • Annals Forum (Archive)
  • Contact
    • Contact Us
  • Careers
  • Follow annalsfm on Twitter
  • Visit annalsfm on Facebook
DiscussionSpecial Reports

Powering-Up Primary Care Teams: Advanced Team Care With In-Room Support

Christine A. Sinsky and Thomas Bodenheimer
The Annals of Family Medicine July 2019, 17 (4) 367-371; DOI: https://doi.org/10.1370/afm.2422
Christine A. Sinsky
1American Medical Association, Chicago, Illinois
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Thomas Bodenheimer
2University of California, San Francisco, San Francisco, California
MD, MPH
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
  • For correspondence: Tombodie3@gmail.com
  • Article
  • Figures & Data
  • eLetters
  • Info & Metrics
  • PDF
Loading

Abstract

Primary care teams are underpowered. Teams do not maximally redistribute team functions when clinicians are diverted from activities where they add the most value. This commentary describes “advanced team care with in-room support” as a way to “power-up” primary care teams. In this core team model, each clinician is paired with 2 or 3 highly trained medical assistants or nurses—care team coordinators (CTCs).Early evidence suggests that this model is more satisfying to clinicians, staff, and patients and is financially sustainable. Yet its spread has been hobbled by several misguided beliefs, such as that the physician can and should do most tasks, that technology replaces people, that health care is a transactional endeavor more than a therapeutic relationship, that regulation is the main lever by which to advance quality, and that the principal way to increase net revenue is to reduce overhead. A shift in mindset is needed to energize primary care.

Key words
  • primary care
  • patient care team
  • Received for publication November 28, 2018.
  • Revision received March 15, 2019.
  • Accepted for publication April 9, 2019.
  • © 2019 Annals of Family Medicine, Inc.
View Full Text
PreviousNext
Back to top

In this issue

The Annals of Family Medicine: 17 (4)
The Annals of Family Medicine: 17 (4)
Vol. 17, Issue 4
July/August 2019
  • Table of Contents
  • Index by author
  • Back Matter (PDF)
  • Front Matter (PDF)
  • In Brief
Print
Download PDF
Article Alerts
Sign In to Email Alerts with your Email Address
Email Article

Thank you for your interest in spreading the word on Annals of Family Medicine.

NOTE: We only request your email address so that the person you are recommending the page to knows that you wanted them to see it, and that it is not junk mail. We do not capture any email address.

Enter multiple addresses on separate lines or separate them with commas.
Powering-Up Primary Care Teams: Advanced Team Care With In-Room Support
(Your Name) has sent you a message from Annals of Family Medicine
(Your Name) thought you would like to see the Annals of Family Medicine web site.
CAPTCHA
This question is for testing whether or not you are a human visitor and to prevent automated spam submissions.
1 + 18 =
Solve this simple math problem and enter the result. E.g. for 1+3, enter 4.
Citation Tools
Powering-Up Primary Care Teams: Advanced Team Care With In-Room Support
Christine A. Sinsky, Thomas Bodenheimer
The Annals of Family Medicine Jul 2019, 17 (4) 367-371; DOI: 10.1370/afm.2422

Citation Manager Formats

  • BibTeX
  • Bookends
  • EasyBib
  • EndNote (tagged)
  • EndNote 8 (xml)
  • Medlars
  • Mendeley
  • Papers
  • RefWorks Tagged
  • Ref Manager
  • RIS
  • Zotero
Get Permissions
Share
Powering-Up Primary Care Teams: Advanced Team Care With In-Room Support
Christine A. Sinsky, Thomas Bodenheimer
The Annals of Family Medicine Jul 2019, 17 (4) 367-371; DOI: 10.1370/afm.2422
Twitter logo Facebook logo Mendeley logo
  • Tweet Widget
  • Facebook Like
  • Google Plus One

Jump to section

  • Article
    • Abstract
    • ADVANCED TEAM CARE WITH IN-ROOM SUPPORT
    • EVIDENCE TO SUPPORT THIS MODEL
    • IMPEDIMENTS TO ADOPTION
    • CHALLENGING THE MINDSETS
    • CONCLUSION
    • Footnotes
    • References
  • Figures & Data
  • eLetters
  • Info & Metrics
  • PDF

Related Articles

  • PubMed
  • Google Scholar

Cited By...

  • Notre contribution a levolution du systeme de sante canadien pour en faire lun des meilleurs au monde: Comment la medecine de famille et les soins primaires peuvent-ils faire evoluer le systeme dans son ensemble?
  • Our role in making the Canadian health care system one of the worlds best: How family medicine and primary care can transform--and bring the rest of the system with us
  • Revitalizing Primary Care, Part 2: Hopes for the Future
  • A Narrative Review of Slow Medicine Outcomes
  • Primary Care 2.0: A Prospective Evaluation of a Novel Model of Advanced Team Care With Expanded Medical Assistant Support
  • Integrating Physical Therapists Into Primary Care Within A Large Health Care System
  • Standardization vs Customization: Finding the Right Balance
  • The Evolving Family Medicine Team
  • Task Sharing Chronic Disease Self-Management Training With Lay Health Coaches to Reduce Health Disparities
  • Google Scholar

More in this TOC Section

  • Family Medicine in Times of War
  • Improving Early Detection of Cognitive Impairment in Older Adults in Primary Care Clinics: Recommendations From an Interdisciplinary Geriatrics Summit
  • Diabetes Management: A Case Study to Drive National Policy Change in Primary Care Settings
Show more Special Reports

Similar Articles

Subjects

  • Other research types:
    • Health services
  • Core values of primary care:
    • Access
    • Continuity
    • Comprehensiveness
    • Coordination / integration of care
    • Personalized care
    • Relationship
  • Other topics:
    • Organizational / practice change
    • Patient-centered medical home

Keywords

  • primary care
  • patient care team

Content

  • Current Issue
  • Past Issues
  • Early Access
  • Plain-Language Summaries
  • Multimedia
  • Podcast
  • Articles by Type
  • Articles by Subject
  • Supplements
  • Calls for Papers

Info for

  • Authors
  • Reviewers
  • Job Seekers
  • Media

Engage

  • E-mail Alerts
  • e-Letters (Comments)
  • RSS
  • Journal Club
  • Submit a Manuscript
  • Subscribe
  • Family Medicine Careers

About

  • About Us
  • Editorial Board & Staff
  • Sponsoring Organizations
  • Copyrights & Permissions
  • Contact Us
  • eLetter/Comments Policy

© 2025 Annals of Family Medicine