Coleman Victoria H, Laube Douglas W, Hale Ralph W, Williams Sterling B, Power Michael L, Schulkin Jay
Research Department, The American College of Obstetricians and Gynecologists, Washington, DC, USA.
Acad Med. 2007 Jun;82(6):602-7. doi: 10.1097/ACM.0b013e3180556885.
To assess obstetrician-gynecologists' perceptions of their residency training in primary care, document health issues assessed at annual visits, and identify practice patterns of both generalist and specialist obstetrician-gynecologists.
Questionnaires were mailed to a random sample of 1,711 American College of Obstetricians and Gynecologists Young Fellows in September 2005. Information was gathered on perceptions about adequacy of residency training, how well training prepared obstetrician-gynecologists for current practice, and typical practice patterns for various medical diagnoses. Data were analyzed using univariate analysis of variance, t tests, and chi-square tests.
Of 935 respondents (55% response rate), physicians estimated that 37% of private, nonpregnant patients rely on them for routine primary care. Approximately 22% report that they needed additional primary care training, specifically for metabolism/nutrition and dermatologic, cardiovascular, and psychosexual disorders. A wide range of topics, except for immunizations, were typically discussed at annual visits. Patients with pulmonary diseases, vascular diseases, and nongenital cancers were most often referred to specialists, whereas patients with urinary tract infections, sexually transmitted infections, or who are menopausal are most often managed totally. Self-identification as a generalist or specialist was associated with some practice patterns. Respondents were neutral about the role of primary care in obstetrics-gynecology residency training.
For several primary care issues, obstetrician-gynecologists assumed sole management for obstetric patients but deferred to a primary care physician for gynecological patients. There is a continuing need for primary care training in obstetrics-gynecology residency, although it is unclear whether current training is adequate to meet their needs.
评估妇产科医生对其初级保健住院医师培训的看法，记录年度就诊时评估的健康问题，并确定普通妇产科医生和专科妇产科医生的执业模式。
2005年9月，问卷被邮寄给1711名美国妇产科医师学会年轻会员的随机样本。收集了关于住院医师培训充分性的看法、培训使妇产科医生为当前执业做好准备的程度以及各种医学诊断的典型执业模式等信息。数据采用方差单因素分析、t检验和卡方检验进行分析。
在935名受访者（回复率55%）中，医生估计37%的非妊娠私人患者依靠他们进行常规初级保健。约22%的医生报告称他们需要额外的初级保健培训，特别是针对代谢/营养、皮肤病、心血管疾病和性心理障碍方面的培训。除免疫接种外，年度就诊时通常会讨论广泛的主题。患有肺部疾病、血管疾病和非生殖器癌症的患者最常被转诊给专科医生，而患有尿路感染、性传播感染或处于更年期的患者大多由医生全程管理。自我认定为普通医生或专科医生与一些执业模式相关。受访者对初级保健在妇产科住院医师培训中的作用持中立态度。
对于几个初级保健问题，妇产科医生对产科患者承担唯一的管理责任，但对妇科患者则会转交给初级保健医生。妇产科住院医师培训仍持续需要初级保健培训，尽管目前的培训是否足以满足他们的需求尚不清楚。
