Pulde M F
Brigham and Women's Hospital PHO, Chestnut Hill, MA, USA.
Physician Exec. 1997 May-Jun;23(5):40-1.
The cost reduction imperative of managed care represents a formidable challenge to the culture of medicine and the values of physicians. The unpredictability of practice has culminated in widespread disenchantment--medicine has lost some of the allure which previously attracted the "best and the brightest." To achieve the goal of increasing the work force of qualified primary care physicians, we must ensure that the practice of medicine remains intellectually challenging, personally gratifying, and that its demands are reasonable and realistic.
管理式医疗降低成本的迫切需求对医学文化和医生价值观构成了巨大挑战。医疗实践的不可预测性最终导致了广泛的不满情绪——医学已失去了一些曾经吸引“最优秀、最聪明人才”的魅力。为了实现增加合格初级保健医生劳动力的目标,我们必须确保医学实践在智力上仍具有挑战性、能给个人带来满足感,并且其要求合理且现实。