• Lawrence P Casalino, Hye-Young Jung, Thomas Bodenheimer, Ivan Diaz, Melinda A Chen, Rachel Willard-Grace, Manyao Zhang, Phyllis Johnson, Yuting Qian, Eloise M O'Donnell, and Mark A Unruh.
• Department of Population Health Sciences, Weill Cornell Medical College, 402 E. 67th St. Room LA 217, New York, NY, 10065-6304, USA. Lac2021@med.cornell.edu.
• J Gen Intern Med. 2023 May 1; 38 (6): 138413921384-1392.

BackgroundPrimary care "teamlets" in which a staff member and physician consistently work together might provide a simple, cost-effective way to improve care, with or without insertion within a team.ObjectiveTo determine the prevalence and performance of teamlets and teams.DesignCross-sectional observational study linking survey responses to Medicare claims.ParticipantsSix hundred eighty-eight general internists and family physicians.InterventionsBased on survey responses, physicians were assigned to one of four teamlet/team categories (e.g., teamlet/no team) and, in secondary analyses, to one of eight teamlet/team categories that classified teamlets into high, medium, and low collaboration as perceived by the physician (e.g., teamlet perceived-high collaboration/no team).Main MeasuresDescriptive: percentage of physicians in teamlet/team categories.Outcome Measuresphysician burnout; ambulatory care sensitive emergency department and hospital admissions; Medicare spending.Key Results77.4% of physicians practiced in teamlets; 36.7% in teams. Of the four categories, 49.1% practiced in the teamlet/no team category; 28.3% in the teamlet/team category; 8.4% in no teamlet/team; 14.1% in no teamlet/no team. 15.7%, 47.4%, and 14.4% of physicians practiced in perceived high-, medium-, and low-collaboration teamlets. Physicians who practiced neither in a teamlet nor in a team had significantly lower rates of burnout compared to the three teamlet/team categories. There were no consistent, significant differences in outcomes or Medicare spending by teamlet/team or teamlet perceived-collaboration/team categories compared to no teamlet/no team, for Medicare beneficiaries in general or for dual-eligible beneficiaries.ConclusionsMost general internists and family physicians practice in teamlets, and some practice in teams, but neither practicing in a teamlet, in a team, or in the two together was associated with lower physician burnout, better outcomes for patients, or lower Medicare spending. Further study is indicated to investigate whether certain types of teamlet, teams, or teamlets within teams can achieve higher performance.© 2022. The Author(s), under exclusive licence to Society of General Internal Medicine.

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