Greer D S
Brown University Program in Medicine, Providence, RI 02912.
J Gen Intern Med. 1990 Jan-Feb;5(1 Suppl):S53-8. doi: 10.1007/BF02600438.
Historically, medicine has regarded itself as a profession of great breadth, encompassing the total range of human activity: biological, behavioral, social and organizational. In the last several decades, however, it has become increasingly reductionist, fragmented, and specialized. Recent developments, as exemplified by the return of the generalist clinician-educator to the academic community, portend a reversal of this trend. Manifestations of a change in the orientation of medicine and medical education toward bolism and bumanism include a movement toward improved compensation for "cognitive" services, development of new promotion tracks for clinician-teachers, and increased support and recognition of applied clinical research. Generalist faculty are in a position to benefit from these trends, but obstacles remain; vigilism and activism are required to maintain momentum.
从历史上看，医学一直将自己视为一门涉猎广泛的专业，涵盖人类活动的各个方面：生物学、行为学、社会学和组织学。然而，在过去几十年里，医学变得越来越还原论化、碎片化和专业化。以通科临床教育工作者回归学术界为例的近期发展，预示着这一趋势的逆转。医学和医学教育在朝着整体论和人文主义方向转变的表现包括：为“认知”服务争取更高薪酬的运动、为临床教师开辟新的晋升途径，以及对应用临床研究的更多支持和认可。通科教师能够从这些趋势中受益，但障碍依然存在；需要保持警惕并积极行动以保持发展势头。
