Teamwork As a Dynamic System

Abstract

Teamwork as a method has been so logically appealing and so seemingly an obvious solution to the " whole man " commitment as well as to the issue of specialization, that the practice has developed without sufficient examination of the premise. Convictions of its value have come chiefly from clinical therapeutic experience and by inference from the many parallels of team operation in business, technological and scientific endeavors. This paper is one of a series which has attempted to define the nature of clinical therapeutic teamwork (9—14). It makes no claim of scientific justification but endeavors to explore some facets of the problem from a descriptive point of view. An effort has been made to interpret the team approach by simple comparisons with more organized and mechanical structures. Logical Basis for Team Approach Before a discussion of the major thesis of this paper, one brief statement on the rationale for a team approach might be useful. The logical assumption of a team is in the form of a simple but ideal equation which may be described thusly: the maximization of information, means, methods, and setting is more likely to supply the maximum product which is the most accurate diagnosis, prognosis, and treatment. The information is maximized by assembling as many different disciplines as may be useful to define the problem, and by acquiring additional information from the case history as well as family, employer, and referring source, and indeed from any medium of knowledge that may be pertinent. Maximizing the means is accomplished by a variety of interviews, examinations , observations, laboratory tests, medical clinical tools such as blood tests, electrocardiograms, neurological tests, and many others as well as by applied tolerance tests such as exercise, range of motion, etc., and furthermore by psychological and vocational testing among other means. Maximizing the method is achieved by a housing in which the patient and team members are available to each other over a period of time and in which various observational opportunities are afforded to the team (15). This is a setting, furthermore, in which the team conference or staffing and other formal or informal meetings are but some of many relationships that exist for communication.