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NEJM Catalyst: The Adverse Impact of the Physician-Hero

Two Cedars-Sinai physicians teamed up with a physician from Massachusetts General Hospital to write a column for NEJM Catalyst that calls for clinicians to embrace a medical team approach to improve outcomes and lower costs.

“For our sickest patients, medical practice has become too complex for one physician to do it all,” the physicians write in the online publication’s Leadership column. “Mortality rates have fallen for many conditions and there is little doubt that routinization and super-specialization have contributed to improved clinical outcomes. Yet, some of the hardest-working physicians have responded to the demand of complex medicine by redoubling efforts to manage all aspects of care.”

NEJM Catalyst is an offshoot from The New England Journal of Medicine that covers innovative ideas and practical applications for enhancing value and outcomes in healthcare.

The clinicians who insist on controlling all aspects of a patient’s care have a deep sense of responsibility and often work tirelessly, the physicians write in NEJM Catalyst. But the unintended result of that dedication often is inefficient and costly, the column says.

“Non-team-based health care tends to be laden with redundancies and inefficiencies to make up for the inability of any individual to be available for complex care 24 hours a day,” the physicians’ column says.

The column was written by Michael Nurok, MBChB, PhD, medical director of the Cardiac-Surgical Intensive Care Unit at the Smidt Heart Institute at Cedars-Sinai; Thoralf Sundt, MD, Chief of the Division of Cardiac Surgery and Director of the Corrigan Minehan Heart Center at Massachusetts General Hospital; and Bruce Gewertz, MD, Surgeon-in-Chief and Vice Dean of Academic Affairs at Cedars-Sinai.

The column concludes, “Like the institutions that they work in, physicians, too, must adopt models for delivering complex care that maintain excellent outcomes and optimize cost. We believe that effective teamwork is an indispensable element for a successful value-based care delivery strategy.”

Click here to read the complete column in NEJM Catalyst

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