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Cultural barriers to teamwork in primary care.

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Chesluk B. — American Board of Internal Medicine

Presented: American Anthropological Association 108th Annual Meeting, December 2009

Abstract: This paper describes anthropology's role in the American Board of Internal Medicine (ABIM)'s assessment of “soft skills” of medical practice. ABIM uses standardized tests of clinical knowledge to assess physicians' competence to practice throughout their career. Recently, ABIM has begun to explore methods of assessing less-tangible areas of medicine, such as teamwork and professionalism. However, a preliminary program of ethnographic research in three primary care practices reveals ways in which the socioeconomic structure of primary care prevents physicians from collaborating with each other and with other members of their practice staff, regardless of their individual characteristics. Current practice structures are focused on supporting physicians' hectic routines and have trouble accommodating the diversity of patients' needs; this represents a significant challenge to efforts to reform primary care. Providers, educators and policymakers who wish to promote better primary care must not focus solely on individual physician abilities or attitudes, but must also address these systemic factors that prevent health care providers from working in teams.

For more information about this presentation, please contact Research@abim.org.