Teamwork in health care in the U.S.: a sociological perspective.

Reactions to teamwork, whether in health care, science and research, or in other areas, are seldom neutral. While some see in it a panacea that will help solve many stubborn organizational problems, others condemn it on a variety of grounds. Impetus to the development of team approaches to the delivery of health care and concern over their performance have been tied to a number of trends: a marked increase in specialization and division of labor as a result of expansion in health-related knowledge and technology, a corresponding emphasis upon coordination, a broadening concept of health and an increase in the types of activities included under its rubric, and a manpower shortage especially in the highly trained professions. This paper reviews current studies, important findings, and points out neglected dimensions. Themes prominent in the literature include: (a) status, power, authority, and influence; (b) roles and professional domains; and (c) decision making and communication. A number of important dimensions seem to be neglected, such as the effectiveness of teams as an approach to the delivery of services, the modes of organization and the dilemma of gate-keeping decisions, and the relations of team approaches to the manpower problems.