Siegal Eric M
University of Wisconsin School of Medicine and Public Health, Madison, WI, USA.
J Hosp Med. 2008 Sep;3(5):398-402. doi: 10.1002/jhm.361.
Medical comanagement has become a mainstay of hospital medicine. Several studies, however, suggest that medical consultation and comanagement may not be as effective as originally anticipated. The expansion of comanagement services has helped fuel massive demand for hospitalists and with it a critical and potentially destabilizing hospitalist manpower shortage. Comanagement may also drive unanticipated consequences such as facilitating surgeon and specialist disengagement and hospitalist career dissatisfaction and burnout. Comanagement services should be developed carefully and methodically, paying close attention to consequences, intended and unintended.
医疗共同管理已成为医院医学的支柱。然而，多项研究表明，医疗会诊和共同管理可能并不像最初预期的那样有效。共同管理服务的扩展助长了对住院医师的大量需求，随之而来的是严重且可能破坏稳定的住院医师人力短缺。共同管理还可能引发意想不到的后果，比如促使外科医生和专科医生脱离工作，以及住院医师职业满意度下降和职业倦怠。应谨慎、有条不紊地发展共同管理服务，密切关注有意和无意产生的后果。
