Wedeen R P, Sheehan H E
VA Medical Center, East Orange, NJ 07019.
Mt Sinai J Med. 1992 Jan;59(1):23-7.
The separation of occupational and environmental disease from the mainstream of medical practice has deep roots in the culture of the profession. Medical practice centered on individual patient care as nineteenth-century science yielded the therapeutic triumphs of the twentieth century. Social issues seemed remote to medical practitioners as the rewards of scientifically based therapies upstaged the unglamorous aspects of preventive medicine. Public health was left to politicians and bureaucrats. Victorian ambivalence toward the less successful members of society reinforced the isolation of medicine from public policy. As a consequence, physicians are largely ignored in contemporary debates about environmental hazards, to the detriment of both society and the profession.
职业疾病和环境疾病从医学实践主流中分离出来，在该行业文化中有着深厚的根源。随着19世纪的科学带来了20世纪的治疗胜利，医学实践以个体患者护理为中心。由于基于科学的疗法的成果使预防医学平淡无奇的方面相形见绌，社会问题对医生来说似乎很遥远。公共卫生被留给了政治家和官僚。维多利亚时代对社会中较不成功成员的矛盾态度加剧了医学与公共政策的隔离。因此，在当代关于环境危害的辩论中，医生基本上被忽视了，这对社会和该行业都不利。
