Shaw Kirstyn, Cassel Christine K, Black Carol, Levinson Wendy
Academy of Medical Royal Colleges, London, England.
JAMA. 2009 Nov 11;302(18):2008-14. doi: 10.1001/jama.2009.1620.
In the United States, Canada, and the United Kingdom, the medical profession is accountable to the public for the delivery and quality of care provided to patients. Traditionally, this accountability has been achieved through the development and maintenance of professional standards established by the profession itself-self-regulation. Medical self-regulation is being re-examined by regulators, government, and the profession in response to a range of drivers including payers seeking ways to hold physicians accountable for cost-effective care; patients seeking more information about their physician's qualifications; and the emergence of a number of high-profile cases of unacceptable medical practice. This article outlines the current state of medical regulation in the United States, Canada, and the United Kingdom and highlights the increasing external pressure on the self-regulatory framework that is leading to a shift toward shared regulation between the profession and other stakeholders.
在美国、加拿大和英国，医疗行业需就为患者提供的医疗服务及其质量向公众负责。传统上，这种问责是通过该行业自身制定并维持的专业标准——自我监管来实现的。监管机构、政府和医疗行业正在重新审视医疗自我监管，这是对一系列驱动因素做出的回应，这些因素包括付款方寻求让医生为具有成本效益的医疗服务负责的方法；患者寻求更多有关其医生资质的信息；以及出现了一些备受瞩目的不可接受的医疗行为案例。本文概述了美国、加拿大和英国医疗监管的现状，并强调了自我监管框架面临的越来越大的外部压力，这种压力正导致向行业与其他利益相关者之间的共同监管转变。
