Peabody J W
Veterans Affairs Medical Center, West Los Angeles, USA.
Acad Med. 1999 Aug;74(8 Suppl):S59-68. doi: 10.1097/00001888-199908000-00031.
This article calls for medical schools to use a new set of standards to gauge how well they contribute to social welfare. Because medical schools receive public funding and are given the authority to certify that providers are sufficiently trained, they incur an obligation to be socially responsible. In addition to setting and using higher standards, medical schools should call on their credibility and use their scientific expertise to find new policies that promote social welfare. In particular, they should do research on socially oriented policies and participate more actively in debates about health sector reform. Although societies vary and have different values, most countries and peoples probably share the following social objectives: They want to use limited public and private resources rationally to produce the best possible health, they do not want individuals or groups to suffer, and they want to protect people against catastrophic illness and associated financial losses. Although new standards are needed, medical schools should be encouraged to continue producing technically sophisticated providers and conducting high-level basic and clinical research. Available evidence suggests that medical schools can further contribute to the three social objectives noted above by increasing the intensity and relevancy of primary care training, expanding the curriculum beyond its biomedical focus, encouraging research in health services, and assessing the effectiveness of social policy in improving the health of the population.
本文呼吁医学院校采用一套新的标准来衡量其对社会福利的贡献程度。由于医学院校接受公共资金并被赋予认证医疗服务提供者是否受过充分培训的权力,因此它们负有社会责任义务。除了制定和采用更高的标准外,医学院校还应利用自身的公信力并运用其科学专业知识来寻找促进社会福利的新政策。特别是,它们应该开展面向社会政策的研究,并更积极地参与有关卫生部门改革的辩论。尽管不同社会有不同的价值观,但大多数国家和民族可能都有以下社会目标:他们希望合理利用有限的公共和私人资源,以实现尽可能好的健康状况;他们不希望个人或群体遭受痛苦;他们希望保护人们免受灾难性疾病及相关经济损失的影响。尽管需要新的标准,但应鼓励医学院校继续培养技术精湛的医疗服务提供者,并开展高水平的基础和临床研究。现有证据表明,医学院校可以通过提高初级保健培训的强度和相关性、拓展课程使其超越生物医学范畴、鼓励开展卫生服务研究以及评估社会政策在改善民众健康方面的有效性,来进一步实现上述三个社会目标。