Langley G R, Till J E
Department of Medicine, Dalhousie University, Halifax, NS.
CMAJ. 1989 Aug 15;141(4):301-7.
To identify the characteristics of exemplary family physicians and consultants, we interviewed 25 family physicians and 25 consultants (5 each in the specialties of internal medicine, obstetrics and gynecology, pediatrics, psychiatry and surgery) selected by their peers as being exemplary in their own practice setting. The results indicated that the participants had well-formulated concepts of exemplary practitioners, defining five main categories of performance: clinical competence, relationship with patients, availability, family physician-consultant relationship and a fifth category that included organizational ability and personality attributes. The family physicians and the consultants placed different values on these categories and indicated that these values might change under different clinical circumstances. Their concepts appear to be compatible with, but not restricted to, a model of contemporary medical practice based on an ethic specific to medicine.
为了确定模范家庭医生和会诊医生的特点,我们采访了25位家庭医生和25位会诊医生(内科、妇产科、儿科、精神病学和外科各5位),这些医生是由同行推选出来的各自执业领域中的模范。结果表明,参与者对模范从业者有明确的概念,定义了五个主要的表现类别:临床能力、与患者的关系、可及性、家庭医生与会诊医生的关系,以及包括组织能力和个性特质在内的第五个类别。家庭医生和会诊医生对这些类别赋予了不同的价值,并表示这些价值在不同的临床情况下可能会发生变化。他们的观念似乎与基于医学特定伦理的当代医疗实践模式相符,但并不局限于此。