JCL Roundtable. The lipidology team.

Clinical lipidology practice works best when implemented by a health care team. The 3 discussants for this JCL Roundtable are National Lipid Association leaders representing essential areas on the team - Registered Dietitian Nutritionist, Advanced Practice Provider, and Clinical Pharmacist. The team approach has been shown more effective than traditional sole provider management for controlling chronic asymptomatic conditions like hypercholesterolemia. Teams also fit better as health care transitions away from fee-for-service into value-based reimbursement. It's worth noting that medicine and even surgery were never entirely solo endeavors. Here we discuss a more expansive team model, which began in the U.S. more than 2 decades ago in the Veterans Administration and certain managed care organizations such as Kaiser Permanente. These health care organizations place themselves at risk, comprising both normative and financial risk, for maintaining their patients' health. Academic medical centers and private health care groups increasingly are adopting the at-risk model and medical teams. Electronic health records facilitate the transition. Team members include not only licensed professionals like our discussants, but also medical assistants, front desk staff, and schedulers. All share decision making and responsibility. Ideally the patient becomes the central member, not merely the focal point, of the team. We explore specific roles within the lipidology team, and we identify continuing barriers to implementation.

Duke Scholars

Author John Richard Guyton Medicine, Endocrinology, Metabolism, and Nutrition