Health care has a love affair with teams. Everybody wants to be a good team player. Not me. I’m still struggling with the distinction between groups and teams in health care. And I think I want to be a groupie.

A lot of health care requires divergent thinking with the ability to converge when we have to.

In a group, I can communicate with others and recognise the value they bring as individuals. Sure, group members only bring to the table what they want to share; but this can provide richness and diversity beyond the confines of the rigidly structured outcomes required from teams.

In a team, members have to work towards a team goal. More often defined by budgetary constraints than effective clinical practice. Teams have their place in health care. Where environments are tightly controlled such as operating theatres and emergency rooms, teams are most appropriate.

However in areas of health care where tasks can’t be rigidly defined and where protocols and single leadership is difficult to enforce or even inappropriate, a team structure may not be the most effective eg  in the intersection between hospitals and communities.

When the team concept was first adopted from the motor industry there were clear distinctions between the two concepts. In a team, members work in a relatively structured environment, they know what boundaries exist and who has final authority. The team leader sets agreed standards of performance for willing participants who share the vision and commitment to the outcome. Team members participate in decisions affecting the team but understand their leader must make a final ruling whenever the team cannot decide.

In a group, conformity is less important than effective communication. Group members find themselves in conflict situations they may not want to resolve nor have the resources to do so. Expressions of opinion or disagreement are considered. They have time to discuss, acknowledge and respect individual motivations. A lot of health care requires divergent thinking with the ability to converge when we have to. That is the way that groups should work.

In our environments where ideologies are so divided, communicating and agreeing to disagree in a group setting might save a lot of time and energy.