Buetow Stephen A
Department of General Practice and Primary Health Care, University of Auckland, Auckland, NZ.
Ann Fam Med. 2005 Nov-Dec;3(6):553-5. doi: 10.1370/afm.342.
Although primary care, including family medicine, recognizes different types of clinician-patient interaction, I argue that only interactions characterized by coprovision define care. By coprovision I mean that clinicians and patients each provide the expertise in health care that they have the capacity to contribute in any given situation. I argue that paternalism and consumerism cannot signify care in any real sense. Some implications of this analysis include a reconceptualization of family medicine and its defining attributes; support for features of caring relationships, such as mutual responsiveness and responsibility; and an acknowledgment that clinicians and patients need to be self-regarding as well as other-regarding. In a previous issue of the Annals, I called for a new dictionary for family medicine, one that would redefine attributes of family medicine in ways not exclusively clinician-centric. Specifically, it would acknowledge the role of patients and their informal caregivers as coproviding, not merely consuming, health care.
尽管包括家庭医学在内的初级保健认识到临床医生与患者互动的不同类型,但我认为只有以共同提供为特征的互动才能定义医疗服务。我所说的共同提供是指临床医生和患者各自提供他们在任何特定情况下有能力贡献的医疗专业知识。我认为家长主义和消费主义在任何实际意义上都不能代表医疗服务。这一分析的一些影响包括对家庭医学及其定义属性的重新概念化;对关怀关系特征的支持,如相互响应和责任;以及承认临床医生和患者既要关注自身也要关注他人。在《内科学年鉴》的上一期中,我呼吁为家庭医学编写一本新词典,一本能以不完全以临床医生为中心的方式重新定义家庭医学属性的词典。具体来说,它将承认患者及其非正式护理人员作为共同提供者而非仅仅是消费者在医疗服务中的作用。