Emeritus professor of general practice, University of Edinburgh, 4 Ravelrig Park, Balerno, Edinburgh EH14 7DL, UK.
Fam Pract. 2014 Feb;31(1):1-6. doi: 10.1093/fampra/cmt079. Epub 2013 Dec 9.
This essay is a personal review of a research journey extending over 50 years during which time the understanding of medical practice has changed out of all recognition and the quality and standing of the discipline of general practice has improved substantially. Three main bodies of work are reviewed and set against the reasons why they were undertaken. The first, on the pathology of the appendix and the management of possible appendicitis, was carried out almost entirely in the hospital setting. The second, about the prescribing of antibiotics for respiratory illnesses, and the third, about the determinants of good consulting practice, were carried out in general practice. The essay concludes with a reflection on the relevance of the work to some contemporary academic and health service issues. Although the work was carried out in the UK in the context of its National Health Service (NHS), the conclusions are widely generalizable and have contributed to health service and academic developments in many other countries.
这篇文章是对我 50 多年来的研究历程的个人回顾，在此期间，医学实践的理解发生了翻天覆地的变化，全科医学的质量和地位也有了显著提高。本文回顾了三项主要工作，并阐述了开展这些工作的原因。第一项是关于阑尾病理学和可能阑尾炎管理的研究，几乎完全是在医院环境中进行的。第二项是关于抗生素治疗呼吸道疾病的处方，第三项是关于良好咨询实践的决定因素，这两项都是在全科医学中进行的。本文最后反思了这项工作与一些当代学术和卫生服务问题的相关性。尽管这项工作是在英国国家医疗服务体系（NHS）的背景下进行的，但结论具有广泛的普遍性，并为许多其他国家的卫生服务和学术发展做出了贡献。
