Vaughan R W, Vaughan M S
University of North Carolina School of Medicine, Chapel Hill, USA.
Physician Exec. 1997 Feb;23(2):4-12.
In only a decade, anesthesiology has reversed its fortunes from an underrepresented specialty in the 1980 Graduate Medical Education National Advisory Committee report to "a specialty in trouble" featured in The Wall Street Journal. This article focuses on anesthesiology and its work force dilemma as an evolving specialist model for change. What is happening to anesthesiology will not be unique--managed care competition will affect all physicians. Most specialties will have to reshape curricula and redesign education programs and academic delivery systems concentrating on fewer trainees. What are the options for coping with physicians grieving over lost dreams, such as autonomy and solo practice, while redesigning a medical specialty? The authors untangle fact from fear, mission from myth, and offer strategic thinking and solutions.
仅仅在十年间，麻醉学就扭转了自身的命运，从1980年研究生医学教育全国咨询委员会报告中代表性不足的专业，变成了《华尔街日报》所描述的“陷入困境的专业”。本文聚焦于麻醉学及其劳动力困境，将其作为一种不断演变的变革专业模式。麻醉学所发生的情况并非个例——管理式医疗竞争将影响所有医生。大多数专业都将不得不重塑课程体系，重新设计教育项目和学术交付系统，减少学员数量。在重新设计一个医学专业时，对于那些因失去诸如自主权和独立执业等梦想而悲伤的医生，有哪些应对之策呢？作者们厘清事实与恐惧、使命与神话，并提供了战略思考和解决方案。
