Bojlén N S, Gannik D E
Afdeling for Almen Medicin, Panum Instituttet, Københavns Universitet, DK-2200 København.
Ugeskr Laeger. 2001 Dec 31;164(1):37-42.
The explosion of biomedical research, and in turn, the far-reaching specialisation, which accompanies it, makes the health service field increasingly obscure and confusing. The general practitioner as gatekeeper occupies a central and much needed role in health care. Inherent this role are the professional core qualities of continuity, entirety, and a personal doctor-patient relationship, which ideally allow the GP to sort out and co-ordinate available services so that they suit the individual patient. These GP qualities also have the merit of making patients more content, they contribute to shared decision making, and they limit costs through more co-ordinated services. General practice today is faced with a dilemma. Increasing specialisation, consumerism, and liberalizsation threaten to eliminate the generalist role in health care, precisely at a time when it is most acutely needed.
生物医学研究的迅猛发展,以及随之而来的影响深远的专业化,使得医疗服务领域变得日益晦涩难懂、令人困惑。全科医生作为守门人,在医疗保健中占据着核心且不可或缺的角色。这一角色内在具备连续性、整体性以及医患个人关系等专业核心特质,理想情况下,这些特质能让全科医生梳理并协调现有的医疗服务,使其契合个体患者的需求。全科医生的这些特质还有助于让患者更加满意,有助于共同决策,并且通过更协调的服务来控制成本。如今的全科医疗面临着两难境地。日益增加的专业化、消费主义和自由化,正威胁着要在医疗保健中消除通科医生的角色,而此时恰恰是最迫切需要这一角色的时候。