The two interwoven elements of medical teamwork, human components and organization, result from two unremitting social processes that are consequences of technical advance. The first is a division of labor—the reduction of complex professional functions into less demanding components. The second is the synthesis of the resulting components into a functioning whole—the organization.
The knowledge and skills required to provide medical care have been continuously and successfully subdivided by specialization and the development of new professional and technical occupations. A satisfactory division of labor and reassignment of professional role has not yet developed for that essential part of medical care implicit in what the physician "professes" (his "profession"), namely, his commitment to undertake medical problem-solving only in trust for the patient.
Competing and mutually exclusive alternatives proposed as the "organizational focus for the health care system of the future" are better understood as different and complementary levels of organization. High quality care depends not only on the effectiveness of each level of organization but on these being meshed into an integrated system.