MEDICC Rev. 2008 Oct;10(4):52. doi: 10.37757/MR2008.V10.N4.9.
In this century, medical schools will be gauged by their capacity to anticipate the kind of doctors required by evolving health systems. They will need to consider the challenges these health systems face as they grapple with critical health concerns in society. In this context, two things immediately become apparent: one, the roots of ill health lie in poverty, discrimination, lack of education, maldistribution and misuse of often scarce resources; and two, in any given country, those who identify health issues, act on health determinants, decide on the use of resources, deliver health services, or train health manpower are usually different groups that may not share the same value system and priorities. Thus, fragmentation is a serious threat to the efficiency and effectiveness of health systems everywhere. These observations set the table for some tough questions: What readjustments do health systems need to make? What roles should doctors play? Which responsibilities should medical schools shoulder to contribute to the development of healthier societies? I like to think that being aware of these overarching issues is a first step towards social accountability.
在本世纪，医学院校将根据其预测不断发展的卫生系统所需医生类型的能力来衡量。它们需要考虑这些卫生系统在应对社会重大健康问题时所面临的挑战。在这种情况下，有两点立即变得显而易见：第一，健康不良的根源在于贫困、歧视、缺乏教育、资源分配不当和滥用往往稀缺的资源；第二，在任何一个国家，那些发现健康问题、对健康决定因素采取行动、决定资源使用、提供卫生服务或培训卫生人力的人通常是不同的群体，他们可能没有共同的价值体系和优先事项。因此，碎片化是各地卫生系统效率和效果的严重威胁。这些观察结果为一些棘手的问题奠定了基础：卫生系统需要进行哪些调整？医生应该扮演什么角色？医学院校应该承担哪些责任，为建设更健康的社会做出贡献？我认为，意识到这些总体问题是实现社会责任的第一步。
