The Difference Between Building a Team and Team Building

In The Boys in the Boat, a masterful account of the University of Washington’s eight-oar crew in the 1936 Olympics in Berlin, author Daniel James Brown offers an insight into what it takes to develop a gold medal-winning team. He also describes the frustration of the university’s rowing coach who kept trying to put together the best combination of people, a task he finally realized relied on temperament, personality and other intangibles as much as it did on physical strength and rowing skills.

Each time he assigned nine young men to a racing shell – eight rowers and a coxswain – he was fulfilling the basic requirement of building a team. But only when he found people who shared common goals, and then sublimated some, but not all, of their personal interests toward those goals, did he engage in true team building. Simply put, he learned that building a team was an action while team building was a concept and a vision.

As you've probably already guessed I think there’s a strong analogy between a well-rowed racing boat and a team approach to primary care medicine.

For over a decade, team building has been at the core of our efforts to help clinical practices transition from a traditional physician-centric model of work distribution to a shared-care approach like Team Care Medicine. Toward that end we are inspired by the work of Thomas Bodenheimer, MD, a Family and Community Medicine practitioner and faculty member of the University of California-San Francisco Medical Center. In his study of high functioning primary care practices, Dr. Bodenheimer shared what he considered to be the key elements of team building:

  • Defined Goals — overall organizational mission statement and measurable operational objectives

  • Understandable Systems — both clinical and administrative

  • Labor Division — clear definition of tasks and clear assignment of roles

  • Training and Cross-Training — for the functions that each team member regularly performs and for other roles

  • Solid communication — structures and processes

In keeping with those elements, and in order for our training strategy to be as effective as possible, it needs to go beyond re-engineering the patient-physician interaction in the exam room. That’s why we also support and guide the physician’s participation in mentorship, delegation, communications, role playing and other team building initiatives. In the new model of primary care that’s built around patients and delivered by teams, these skills are becoming more and more essential.

Because whether you’re racing an eight-oar racing shell through the water or providing primary care that’s comprehensive, preventive, efficient and effective, there’s no substitute for pulling together.