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医患对话——医疗会诊的基本方面。

Doctor-patient dialogue--basic aspect of medical consultation.

作者信息

Murariu-Brujbu Isabella Cristina, Macovei Luana Andreea

机构信息

Discipline of Family Medicine, Faculty of Medicine, University of Medicine and Pharmacy Grigore T. Popa, Iaşi.

Discipline of Rheumatology and Balneophysiotherapy, Faculty of Medicine, University of Medicine and Pharmacy Grigore T. Popa, Iaşi.

出版信息

Rev Med Chir Soc Med Nat Iasi. 2013 Jan-Mar;117(1):113-8.

Abstract

Family medicine is the specialty that provides ongoing primary medical care and improves the health status of the individual, of the family and of the community through preventive, educational, therapeutic and rehabilitation measures. The family doctor often makes the interdisciplinary synthesis, in a flexible manner, either alone or in most cases with interdisciplinary consultation. In the latter case, the family doctor initiates the team work and makes the final evaluation by using the longitudinal follow-up of the disease. The doctor-patient encounter represents the "confrontation" with the greatest moral weight, due to the complexity of the values involved, the status of the doctor in a society, and patient's involvement in decision making. The patient is a person who should be treated with respect, honesty, professionalism and loyalty, whatever the clinical status, severity of illness, mental competence or incompetence. A focus, on an international scale, is represented by the characteristics of a good doctor, family physician included, as the latter is the first link in the network of health services. Each model of consultation varies in a more or less subtle way in priorities assignment, and suggests slight differences regarding the role played by doctor and patient in their collaboration. The qualities of a good family physician include not only the strictly professional competences, that also apply to other medical specialties, but also duties, such as, clearly explaining to patients issues concerning their health, informing them about all the possible preventive measures of diseases, making a diagnosis, initiating and supervising a therapy. Medical responsibility lies at the crossroads between medical science and the conscience of the doctor.

摘要

家庭医学是一门通过预防、教育、治疗和康复措施提供持续初级医疗保健并改善个人、家庭和社区健康状况的专业。家庭医生通常以灵活的方式进行跨学科综合,既可以独自进行,也在大多数情况下通过跨学科会诊来完成。在后一种情况下,家庭医生发起团队合作,并通过对疾病的纵向随访进行最终评估。医患会面由于所涉及价值观的复杂性、医生在社会中的地位以及患者参与决策等因素,代表着具有最大道德分量的“对抗”。无论患者的临床状况、疾病严重程度、精神能力如何,都应受到尊重、诚实、专业和忠诚的对待。在国际范围内,一个关注点是优秀医生(包括家庭医生)的特质,因为家庭医生是卫生服务网络的第一环。每种会诊模式在优先级分配上或多或少存在细微差异,并在医患合作中各自所扮演的角色上暗示了些许不同。优秀家庭医生的品质不仅包括适用于其他医学专业的严格专业能力,还包括一些职责,比如向患者清晰解释有关其健康的问题,告知他们所有可能的疾病预防措施,进行诊断,启动并监督治疗。医学责任处于医学科学与医生良知的交叉点上。

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