Braddock Clarence H, Snyder Lois
Department of Medicine, Stanford University School of Medicine, Stanford, Calif 94305, USA.
J Gen Intern Med. 2005 Nov;20(11):1057-62. doi: 10.1111/j.1525-1497.2005.00217.x.
Many physicians and health care leaders express concern about the amount of time available for clinical practice. While debates rage on about how much time is truly available, the perception that time is inadequate is now pervasive. This perception has ethical significance, because it may cause clinicians to forego activities and behaviors that promote important aspects of the patient-physician relationship, to shortcut shared decision making, and to fall short of obligations to act as patient advocates. Furthermore, perceived time constraints can hinder the just distribution of physician time. Although creating more time in the clinical encounter would certainly address these ethical concerns, specific strategies-many of which do not take significantly more time-can effectively change the perception that time is inadequate. These approaches are critical for clinicians and health systems to maintain their ethical commitments and simultaneously deal with the realities of time.
许多医生和医疗保健领导者对可用于临床实践的时间量表示担忧。虽然关于真正可用的时间量的争论激烈,但时间不足的观念现在已普遍存在。这种观念具有伦理意义,因为它可能导致临床医生放弃促进医患关系重要方面的活动和行为,简化共同决策,并未能履行作为患者倡导者的义务。此外,感知到的时间限制可能会阻碍医生时间的公平分配。虽然在临床接触中创造更多时间肯定能解决这些伦理问题,但一些具体策略——其中许多并不需要花费更多时间——可以有效改变时间不足的观念。这些方法对于临床医生和医疗系统维持其伦理承诺并同时应对时间现实至关重要。