Hurd W W, Barhan S M, Rogers R E
Department of Obstetrics and Gynecology, Wright State University, Dayton, OH 45409, USA.
Am J Manag Care. 2001 Sep 25;7 Spec No:SP19-24.
Obstetrics and gynecology is a unique field that combines preventive and primary care with female pelvic surgery and obstetrics. With the evolution of managed care, it has been a challenge to fit this field into the standard primary care paradigm. This article describes a 3-tiered, patient-oriented definition of primary care that encompasses the essential aspects of all primary care specialties, followed by a critical examination of how primary care specialties, including obstetrics and gynecology, fit into this definition. This approach suggests that to better meet the primary care needs of both patients and society, obstetrician-gynecologists must continue to improve their skills in preventive care, diagnosis and treatment of self-limited conditions, and diagnosis of serious nongynecologic conditions.
妇产科是一个独特的领域，它将预防保健和初级保健与女性盆腔手术及产科相结合。随着管理式医疗的发展，将这一领域纳入标准的初级保健模式一直是一项挑战。本文描述了一个以患者为导向的初级保健的三层定义，该定义涵盖了所有初级保健专科的基本方面，随后对包括妇产科在内的初级保健专科如何符合这一定义进行了批判性审视。这种方法表明，为了更好地满足患者和社会的初级保健需求，妇产科医生必须继续提高他们在预防保健、自限性疾病的诊断和治疗以及严重非妇科疾病的诊断方面的技能。
