The professionals link up their services as required for each case. Let us now look at the structures within which the professionals can deliver their services in the context of team care. Structures, which are already with us, include the polyclinic, the medical centre, hospitals, family service centres, scattered medical practices and home nursing teams. They are all tried and tested institutions, which we can use effectively for team care. In the Medical Centre, professionals generally work independently.
Coordination regarding patient care is usually by telephone or at the bedside.
The patient shuttles about and pays multiple fees, and this is a disadvantage. The Polyclinic offers one-stop care and a single bill, which is a great convenience. It tends to have a pyramid hierarchy, which is usually headed by a doctor. The pyramid structure may not make optimum use of all professionals, and it is difficult to include a large range of services in the usual smallish organisation. The Government Polyclinics' have kept up with the changing pattern of disease in Singapore by introducing health promotion programs and screening for coronary heart disease in addition to their traditional activities of antenatal and well-baby care, and outpatient treatment of illnesses.