The complexity, diversity, and science of primary care teams.
Abstract
This article examines the past, present and future of primary care and teamwork. It begins with a definition and description of primary care-its uniqueness, diversity and complexity, including the historical role of teams within primary care. The article then reviews the emergence of innovative primary care teams, including those grounded in new processes such as the Patient-Centered Medical Home and interprofessional teams that include new types of health professionals, particularly psychologists and other integrated behavioral health clinicians. The article describes key factors that support or hinder primary care teamwork, as well as evidence of the impact of these team-based models on patient outcomes, costs, and team members. It also discusses the role of primary care teams within multiteam systems (or 'teams of teams'), which are organized around the needs of patients and families, and the unique challenges these systems pose to coordinating care. The article concludes with recommendations for advancing teams in primary care, including changes in payment, descriptions of team competencies, models for primary care team training, and research necessary to inform the gaps in scientific knowledge. (PsycINFO Database Record
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Effective team-based care and higher quality teamwork are associated with improvements in care access and quality, patient safety, patient satisfaction, clinical outcomes, and costs.
“Effective team-based care and higher quality teamwork are associated with improvements in care access and quality, patient safety, patient satisfaction, clinical outcomes, and costs [2, 4–9].”
From Teamwork and implementation of innovations in healthcare and human service settings: a systematic review (2024) · cites this paper as [6]
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The Cost to Successfully Apply for Level 3 Medical Home Recognition
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The Diversity of Providers on the Family Medicine Team
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Insights from Exemplar Practices on Achieving Organizational Structures in Primary Care
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At a Crossroads: The Future of Primary Care Education and Practice
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The science of teamwork: Progress, reflections, and the road ahead.
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Cross-Disciplinary Care: A Systematic Review on Teamwork Processes in Health Care
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An Introduction to Community and Primary Health Care
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Self-citationToward the Development of the Perfect Medical Team: Critical Components for Adaptation
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Role of Occupational Therapy in Primary Care
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Community health needs assessment
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Team Functioning and Performance in Child Advocacy Center Multidisciplinary Teams
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Addressing Medication Costs During Primary Care Visits: A Before–After Study of Team-Based Training
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Self-citationThe Impact of COVID-19 on Primary Care Teamwork: a Qualitative Study in Two States
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Barriers and facilitators to lifestyle risk communication by Australian general practice nurses
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A Review of the Sport-Injury and -Rehabilitation Literature: From Abstraction to Application
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Churning the tides of care: when nurse turnover makes waves in patient access to primary care
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Cross-Disciplinary Care: A Systematic Review on Teamwork Processes in Health Care
Dinh, J. V., Traylor, A. M., Kilcullen, M., Perez, J. A., Schweissing, E. J., Venkatesh, A., & Salas, E. (2019) · Sage Journals Data · doi:10.25384/sage.c.4666325 · Cited by 16 · see citing works
Effects of Health Care Payment Models on Physician Practice in the United States: Follow-Up Study
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An Introduction to Community and Primary Health Care
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Patterns of Psychologists’ Interprofessional Collaboration Across Clinical Practice Settings
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Managing chronic health conditions
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The who, what, and how of teamwork research in medical operating rooms: A scoping review
Raveendran, L., McGuire, C. S., Gazmin, S., Beiko, D. T., & Martin, L. J. (2022) · Journal of Interprofessional Care · doi:10.1080/13561820.2022.2058917 · Cited by 13 · see citing works
Proposed Requirements for Behavioral Health in Family Medicine Residencies
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Self-citationImplementing Parenting Programs in Primary Care: A Framework and a Call for Action
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Sport Psychology: Principles and Practices for Sports Medicine Physicians
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What can we learn from COVID-19?: examining the resilience of primary care teams
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An Introduction to Community and Primary Health Care
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Using the PACT Resources Framework to Understand the Needs of Geriatric Primary Care Teams
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Timely Care is Patient‐Centered Care for Patients with Acute Cholecystitis at a Safety‐Net Hospital
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Interprofessional Education and Training
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Managing chronic health conditions
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Community‐based dementia care re‐defined: Lessons from Iceland
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Mastery Learning of Team Skills
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Primary care physical therapy: 2025 consensus definition
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Child Psychiatrists and Psychologists
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Community and primary health care
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Effective Teamwork and Healthcare Delivery Outcomes
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The influence mechanism analysis of family doctor team effectiveness: a mixed-method approach
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Let’s Get Physical: Physical Activity as a Team Intervention at Work
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Diagnosing conflict in clerkship: insights from medical students’ experiences
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Confronting the Post—ACA American Health Crisis
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Self-citationFinding and fueling your professional passion
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Health and Healthcare as Infinite Games
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Montesanti, S. R., Fleming, E., Furlano, J. A., Sjoblom, E., Oster, R. T., Roach, P., Roy, A., & Crowshoe, L. L. (2025) · SSM - Health Systems · doi:10.1016/j.ssmhs.2025.100109 · Cited by 1 · see citing works
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- Authors
- Fiscella, K., & McDaniel, S. H.
- Affiliations
- University of Rochester Medicine (US)
- Venue
- American Psychologist
- Published
- 2018-05
- Volume
- 73
- Issue
- 4
- Pages
- 451-467
- ISSN
- 0003-066X (ISSN-L)
- 1935-990X
- OpenAlex
- W2804270352
- Semantic Scholar
- b603433ea33e36806a45bbc07476f40f295cbc76
- Cited by
- 155
- References
- 114
- Citations by year
- 2026: 10 · 2025: 15 · 2024: 14 · 2023: 14 · 2022: 14 · 2021: 16 · 2020: 47 · 2019: 12 · 2018: 12 · 2017: 1
- FWCI
- 33.21
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- American Psychologist (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Health Professions › General Health Professions › Interprofessional Education and Collaboration
- Health Sciences › Health Professions › General Health Professions › Primary Care and Health Outcomes
- Social Sciences › Psychology › Social Psychology › Team Dynamics and Performance
- Keywords
- primary health care teams, teamwork, patient-centered medical home, multidisciplinary team, behavioral health integration, multiteam systems, team-based care, care coordination, team competence, team training, payment reform, history of primary care
- MeSH terms
- Intersectoral Collaboration, Humans, Interprofessional Relations, Patient Care Team, Primary Health Care
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