Calman Neil S, Hauser Diane, Leanza Francesco, Schiller Robert
The Institute for Family Health, New York, NY, USA.
Mt Sinai J Med. 2012 Sep-Oct;79(5):603-9. doi: 10.1002/msj.21333.
After a diminishing of its ranks following the post-World War II explosion of growth in medical discoveries, advanced medical technology, and the concomitant specialization of the physician workforce, family medicine is re-establishing itself as a leading medical specialty that has garnered growing interest among recent medical-school graduates. Family physicians provide care for patients of all ages, from newborns to the elderly. In addition to its wide scope of practice, family medicine is characterized by its emphasis on understanding of the whole person, its partnership approach with patients over many years, and its command of medical complexity. Family physicians are trained both to use community resources to assist individual patients in meeting medical or social needs and to identify and address community-wide needs. The specialty of family medicine is uniquely positioned to provide a leadership role in health-reform efforts that are accelerating across the country. Health care models that are gaining traction, such as the patient-centered medical home model, health homes, and accountable care organizations, share the characteristics of providing comprehensive, coordinated patient care with an emphasis on disease prevention and health promotion. This model of care, provided in the context of family and community, has been the hallmark of family medicine since its creation as a distinct medical specialty more than 40 years ago. In addition, family physicians' ability to care for patients of all ages make them particularly cost-effective as the new models of care move to improve access to care through expanded hours and locations.
在二战后医学发现、先进医疗技术呈爆发式增长以及随之而来的医师队伍专业化导致其规模缩减之后,家庭医学正在重新确立自身作为一个领先医学专科的地位,并且在最近的医学院毕业生中引起了越来越浓厚的兴趣。家庭医生为从新生儿到老年人的各年龄段患者提供护理。除了广泛的执业范围外,家庭医学的特点还在于强调对整个人的了解、多年来与患者建立的伙伴关系以及对医疗复杂性的掌控。家庭医生既要接受培训,利用社区资源协助个体患者满足医疗或社会需求,也要识别和解决社区层面的需求。家庭医学专科在全国加速推进的医疗改革努力中具有独特的地位,能够发挥领导作用。正在获得广泛认可的医疗模式,如以患者为中心的医疗之家模式、健康之家模式和责任医疗组织模式,都具有提供全面、协调的患者护理并强调疾病预防和健康促进的特点。自40多年前作为一个独特的医学专科创立以来,在家庭和社区背景下提供的这种护理模式一直是家庭医学的标志。此外,随着新的护理模式通过延长服务时间和增设服务地点来改善医疗服务可及性,家庭医生照顾各年龄段患者的能力使他们具有特别高的成本效益。