Pitchforth Emma, Roland Martin
RAND Europe, Westbrook Centre, Cambridge, UK.
Cambridge Centre for Health Services Research, University of Cambridge, Cambridge, UK.
Future Hosp J. 2015 Oct;2(3):173-179. doi: 10.7861/futurehosp.2-3-173.
The aim of this study was to understand, from consultants' experiences, the potential benefits and limitations of specialists being employed by a community organisation. We carried out a qualitative study using semi-structured interviews with consultants holding novel contracts across three specialties: geriatric, respiratory and palliative medicine. Consultants in our study reported that community-based roles offered a number of potential benefits. They felt better able to take a population perspective, to treat patients in a holistic sense and to form good working relationships with community-based colleagues. A number of challenges were also evident, including a lack of clarity about their role, professional isolation and, for those in geriatric and respiratory medicine, a lack of training and career development opportunities. Our study suggests that community-based consultant posts are often taken up by highly motivated individuals who report the benefits in terms of being able to provide more appropriate care for patients but that the long-term development of these posts may be constrained by a number of factors. Their idiosyncratic nature, the lack of clarity around the role, challenges to professional identity and lack of training opportunities or professional development suggest that current approaches to their development may not be sustainable.
本研究的目的是从顾问的经验中了解社区组织聘用专科医生的潜在益处和局限性。我们开展了一项定性研究，对持有新型合同的老年医学、呼吸医学和姑息医学三个专科的顾问进行了半结构化访谈。我们研究中的顾问报告称，基于社区的工作岗位有诸多潜在益处。他们觉得更有能力从人群角度出发，从整体上治疗患者，并与社区同事建立良好的工作关系。一些挑战也很明显，包括他们的角色不明确、职业孤立，以及对于老年医学和呼吸医学领域的顾问来说，缺乏培训和职业发展机会。我们的研究表明，基于社区的顾问岗位通常由积极性很高的人担任，他们报告称能够为患者提供更合适的护理，但这些岗位的长期发展可能受到多种因素的制约。这些岗位的特殊性质、角色不明确、职业身份面临的挑战以及缺乏培训机会或职业发展，表明目前这些岗位的发展方式可能不可持续。
