FROM SILOS TO SYNERGY
Collaborative Care in the age of AI
Who is the real leader of the band? by John J. Wernert, MD
Being part of a team always felt right for me. Coming from a large family and attending parochial schools, I always assumed that working together would get the best outcomes. Whether family projects, sports team, Scouts, social groups or church organizations, fraternal efforts helped the group win games and accomplish more than any one individual. As our schooling progressed and our lives moved on, those of us who chose medicine became well-versed in the benefit and importance of care coordination. I likened it to my time in the high school marching band.
Our Band Director was the seasoned adult who selected the show music, coordinated the drills, ran the rehearsals and administered the schedules. It was one of our peers, the Drum Major, who taught the steps, coordinated the music and conducted the show. Each band section had a leader who was responsible for each instrumental group. The hierarchy, when working well together, created a successful show. Even with practice, the performance was only as good as the weakest player. Each year with new freshmen joining the band, the teaching cycle started all over again as the seniors attempted to train the troops and raise the bar to improve musicality and showmanship. Realistically, we were inexperienced teenagers dressed in uniforms performing marching routines during halftime of high school football games. Directing medical care is exponentially more challenging.
As our patients age and are living with numerous complicated chronic conditions, now more than ever we need regular coordination and communication between different parts of the healthcare system. Patients are human and therefore desire the human touch especially when making life and death decisions. In this crude band metaphor lies the challenges that collaborative care faces in our clinics. Could we imagine a band or orchestra without a human conductor? Is compassion and hand-holding still necessary when caring for fellow humans in need?
Consider the structure we grew up in. Our health system and hospital“ Directors” administer the hospital enterprise and clinical programs, but it requires physician“ drum majors” to provide and conduct the actual care. Physicians are uniquely qualified to serve as peer leaders, but have we lost our clout as teachers and decision-makers? It is now
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