Department of Medicine, Stanford University, Palo Alto, California, USA.
Extended Care and Palliative Medicine Service, Veterans Affairs Palo Alto Health Care System, Palo Alto, California, USA.
J Palliat Med. 2022 Feb;25(2):193-199. doi: 10.1089/jpm.2021.0644. Epub 2022 Jan 19.
The issue of generalist versus specialist palliative care is on the minds of healthcare leaders everywhere. We are amid changing demographics of physicians. The industrialization of medicine is well underway in the US and around the developing world. Is it important to identify patients who benefit the most from specialist palliative care, given that it is currently a limited resource? Should we step out of standard practice and redesign palliative care using principles of population management? The COVID pandemic rapidly introduced virtual palliative care consults. Is it a better way to promote wide access to specialty palliative care? Looking forward, should we promote ways to advance primary palliative care and reserve specialty palliative care to patients who will benefit most from this level of care? These questions, and others, are considered in this transcribed discussion between leading physicians in the field.
通才与专科姑息治疗之争是各地医疗保健领导人关注的问题。我们正处于医生群体人口统计学变化之中。医学的工业化在美国和发展中世界都在进行中。鉴于专科姑息治疗目前资源有限,确定哪些患者最能从中受益是否很重要?我们是否应该跳出标准实践,采用人群管理原则重新设计姑息治疗?COVID 大流行迅速引入了虚拟姑息治疗咨询。这是否是促进广泛获得专科姑息治疗的更好方法?展望未来,我们是否应该推广推进初级姑息治疗的方法,并将专科姑息治疗保留给最能从这种护理水平中受益的患者?在本次领域内领先医生的转录讨论中,对这些问题和其他问题进行了探讨。