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First a note of self-disclosure: Many years ago, one of my early jobs in health care was setting up and running a transdiciplinary team (physicians, educators, neuro-developmental therapists (OT,PT), social workers, and psychologists) to work with children, birth to three years, with severe disabilities — and their families. This was, and continues to be, a fairly radical approach to health care delivery. Anyway, my experience leading that team framed my understanding from that time forward about the nature of professional disciplines, the clinical usefulness of blurring the lines that separate the disciplines, and the resistance that such a model engenders from those too embedded in their professional identity to break out of the envelope. Subsequent career work in the health care industry in the many years since has only reinforced a skepticism of professional boundaries and the turf battles they engender, or the special prerogatives they demand.

So it is with this as an opening admission, that I want to speculate on the new team for medical work that I suspect will evolve in some form as medicine changes its basic paradigms of care under the growing impact of technology, cost and the complexity of access. Thus maybe sometime in the not so distant future, the typical team managing your health care will look something like this:

Team Leader — Ideally this would be you, the patient, of course. If that’s not feasible, then an independent patient advocate (or family member) would be enlisted to take on that role. In may be that almost every member of the team and clinical sub-team considers themselves as your advocate, but this would be the official one. If need be, Power of Attorney, pursuing Advance Directives, and other highly personal (and spiritual) issues would be handled through this person.

Patient Navigator — This person works would work with you to identify quality clinicians appropriate to your needs and help put together the clinical sub-team that could be located across the community, the state, the country or the world for that matter. This team member acts to ensure communications are attended to among the team and clinical sub-team members — team CIO, in other words — and acts as the ‘re-entry’ coordinator after any period of institutional or hospital care.

Clinical Manager — Here a physician, or another suitable clinical profession heads up and coordinates your clinical sub-team of medical specialists needed for the direct delivery of everyday medical care.

Genetics Manager — In the coming era of personalized medicine and the growing importance of genetic testing, genetic counseling and decision-making, gene-sensitive drug selection — you will need this skill set to be in the loop.

Technical Coordinator — Responsible for the quality and appropriateness of the major digital and information technologies used in your on-going care such as monitoring devices, remote sensors, EMR fulfillment, home care technical design among other duties.

Financing and Cost Manager — Tracking and negotiating your health care and other costs, managing your insurance benefits, seeking alternative funding mechanisms for high expenses will be full time work if you experience a serious illness or injury. This person works to secure the your financial interest.

As important as who is on the team, is how the team works together to advance the your medical care. How will clinical differences and family conflicts be handled, for example. How will errors in care be identified and addressed? The team members have to bring the issues to the table. But the managing of those issues will be a critical distinguishing factor in the quality of the care delivered.

So good luck with the new guys. And while the team may be new, human nature may still be the same. Keep an eye on them.