The Myth of the Lone Physician: Toward a Collaborative Alternative

Abstract

Cultural values and beliefs about the primary care physician bolster the myth of the lone physician: a competent professional who is esteemed by colleagues and patients for his or her willingness to sacrifi ce self, accept complete responsibility for care, maintain continuity and accessibility, and assume the role of lone decision maker in clinical care. Yet the reality of current primary care models is often fragmented, impersonal care for patients and isolation and burnout for many primary care physicians. An alternative to the mythological lone physician would require a paradigm shift that places the primary care physician within the context of a highly functioning health care team. This new mythology better fulfi lls the collaborative, interprofessional, patient-centered needs of new models of care, and might help to ensure that the work of primary care physicians remains compassionate, gratifying, and meaningful.

Effect of Continuity of Care on Hospital Utilization for Seniors With Multiple Medical Conditions in an Integrated Health Care System

“…Advocates of these models point out that better care coordination improves utilization outcomes, that there is a valid (if relatively unexplored) construct of team continuity, and that such care models provide new technology-based opportunities for patient-clinician communication. 7,30,43 Evaluations of patient-centered medical home practice transitions have been inconclusive, however. [44][45][46][47] It remains to be seen whether and how new models of care affect relationships that are meaningful to patients as well as outcomes that are important to delivery systems.…”

Implementing a patient centered medical home in the Veterans health administration: Perspectives of primary care providers

“…22 As Saba and colleagues have noted, "In our profession's efforts to create [high functioning health care teams] we have yet to articulate a myth that takes us from the lone physician to the team-based physician." 23 The lack of a "myth" to foster PACT function may be in part due to a lag between the speed of individuals to adopt change and the speed of the larger organization to align leadership goals at multiple levels. While the PACT model compels multi-level organizational change, implementation emphasized bottom-up innovation.…”

Forces for Integration

“…20 A vague sense of loss developed among both healers and those in need of healing and became the impetus for grounding but reimagining the role of the healer for a new era. [23][24][25][26][27] That drive to recognize, reinvent, and support horizontal integration in health care is struggling to burst forth with force, even today.…”