• Mingliang Dai, Rachel Willard-Grace, Margae Knox, Samantha A Larson, Michael K Magill, Kevin Grumbach, and Lars E Peterson.
• From American Board of Family Medicine, Lexington, KY (MD, LEP); Center for Excellence in Primary Care, Department of Family & Community Medicine, University of California, San Francisco (RW-G, KG); University of California, Berkeley (MK); University of Florida, Gainsville (SAL); Department of Family and Preventive Medicine, University of Utah, Salt Lake City (MKM); Department of Family and Community Medicine, University of Kentucky, Lexington (LEP). mdai@theabfm.org.
• J Am Board Fam Med. 2020 May 1; 33 (3): 368-377.

IntroductionThe delivery of team-based care relies on team structure and teamwork. Little is known about the landscape of team configurations in family medicine practices in the United States. Teamwork between diverse team members likely impacts both performance and physician well-being. We examined team configuration and teamwork and whether they are associated with family physician (FP) well-being.MethodsWe used data from practice demographic questionnaires completed by FPs who registered for the American Board of Family Medicine Family Medicine Certification Examination in 2017 and 2018. We grouped 14 types of health care professionals into medical assistant (MA)/nurse, nurse practitioner (NP)/physician assistant (PA), and specialist, and we characterized 3 common team configurations. We used FPs' subjective ratings to measure perceived teamwork efficiency and a validated single-item measure to identify FPs who were burned out.ResultsAmong 2575 FPs in our sample, 22% worked collaboratively with MA/nurse only; 40% with MA/nurse and NP/PA or specialist; and 38% with MA/nurse, NP/PA, and specialist. The distribution of perceived teamwork efficiency was not statistically different across team configurations. In teams with greater perceived teamwork efficiency, FPs were less likely to be burned out. For FPs working with expansive teams, optimal perceived teamwork efficiency was associated with significantly reduced odds of burnout after controlling for practice and physician characteristics.ConclusionMost FPs practice in multidisciplinary teams. Regardless of the team structure, FPs who perceived their teams as having greater efficiency were less likely to be burned out. We found that optimal perceived teamwork efficiency was associated with significantly reduced odds of burnout for FPs in all types of team configurations. Improving teamwork efficiency may be an effective strategy for practice organizations to support not only team functioning but also physician well-being.© Copyright 2020 by the American Board of Family Medicine.

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