Yarnall Kimberly S H, Østbye Truls, Krause Katrina M, Pollak Kathryn I, Gradison Margaret, Michener J Lloyd
Department of Community and Family Medicine, Duke University Medical Center, Durham, NC 27710, USA.
Prev Chronic Dis. 2009 Apr;6(2):A59. Epub 2009 Mar 16.
A major contributor to shortfalls in delivery of recommended health care services is lack of physician time. On the basis of recommendations from national clinical care guidelines for preventive services and chronic disease management, and including the time needed for acute concerns, sufficiently addressing the needs of a standard patient panel of 2,500 would require 21.7 hours per day. The problem of insufficient time indicates that primary care requires broad, fundamental changes. The creation of primary care teams that include members such as physician assistants, nurse practitioners, dietitians, health educators, and lay coaches is important to meeting patients' primary care needs.
提供推荐的医疗服务存在不足的一个主要原因是医生时间短缺。根据国家预防服务和慢性病管理临床护理指南的建议，并包括处理急性问题所需的时间，充分满足2500名标准患者群体的需求每天需要21.7小时。时间不足的问题表明初级保健需要广泛、根本性的变革。组建包括医师助理、执业护士、营养师、健康教育工作者和非专业教练等成员的初级保健团队对于满足患者的初级保健需求很重要。
