Department of Family Medicine and Community Health, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin
Department of Family Medicine and Community Health, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin.
Ann Fam Med. 2024 Sep-Oct;22(5):453-455. doi: 10.1370/afm.3144.
We primary care clinicians, scholars, and leaders ascribe value to Barbara Starfield's core tenets of primary care-the 4 Cs: first contact, comprehensiveness, coordination, and continuity. In today's era of rapid technological advancements and dwindling resources, what are the implications for face-to-face interactions of patient-clinician relationships? We propose adding a 5th C: "Contiguity." Contiguity-or physical proximity and presence-is a key dimension that not only enables the necessary technical aspects of a physical exam but also authenticates the most human aspects of a relationship and occurs specifically when we are physically vulnerable and responsible for the other before us. This, in turn, may best enable us to bridge difference and nurture trust with our patients. We measure what we value and, thus, naming Contiguity as a core tenet assures that we will not lose sight of this keystone in a patient's relationship with their personal physician.
我们初级保健临床医生、学者和领导者非常重视芭芭拉·斯塔菲尔德（Barbara Starfield）关于初级保健的核心原则——“4C”：首诊、全面性、协调性和连续性。在当今快速发展的技术和资源日益减少的时代，医患关系的面对面互动意味着什么？我们建议增加第五个“C”：“临近性”。临近性或身体上的接近和在场是一个关键的维度，它不仅使身体检查的必要技术方面成为可能，而且还使关系中最人性化的方面得到验证，并且只有当我们在身体上脆弱并对面前的人负责时才会发生。这反过来又可能使我们能够与患者建立联系并建立信任。我们衡量我们重视的东西，因此，将临近性命名为核心原则可以确保我们不会忽视患者与他们的私人医生关系中的这个关键因素。
