AMA Adopts Ethical Guidance on Team-Based Health Care

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AMA Ethical Guidance for Physicians on Team-Based Health Care

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

  • Promote core team values of honesty, discipline, creativity, humility, 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
  • 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.

Team-based health-care models are emerging as preferred methods for providing coordinated, cost-effective and high-quality health care for patients. Earlier this month, the American Medical Association (AMA) announced its adoption of ethical guidance for physicians as leader-members of care teams.

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 training, experience, and knowledge, physicians have a distinct appreciation of the breadth of health issues and available treatment options, which enable them to integrate the diverse professional perspectives and recommendations of the health-care team into an appropriate, coherent plan of care for the patient.

Collaborative Care Guidance

“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. A former senior executive at General Motors from Nashville, Mr. Williams was elected to the AMA’s Board of Trustees earlier this month. He is the fourth person ever to hold the public member position on the governing board of the AMA.

Mr. Williams added: “An effective team requires vision and direction of an effective leader, and the physician is 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; clearly articulating individual responsibilities and accountability; encouraging insights from other members and being open to adopting them; and mastering broad teamwork skills.

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 8-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. ■