Klein M
Can Med Assoc J. 1985 Mar 15;132(6):629-33.
Whether and how much the departments of pediatrics in Canadian medical schools collaborate with the family medicine departments in training for child care were the focus of a survey conducted in 1983-84. Responses to a questionnaire sent to department heads indicated that in general the most supportive relationships existed in the western provinces, with progressively more problems uncovered from west to east. The responses concerning the roles of pediatricians and family physicians paralleled this trend, with the western view being that pediatricians are consultants and not competitors for primary care. Many respondents supported the expansion of family medicine, particularly into ambulatory and behavioural areas. The data provide some cause for concern about the future health care of children, as the forecasted oversupply of physicians is likely to encourage competition rather than consultation between the two groups. Also, many Canadian pediatricians accept the US model of pediatrics, which includes primary care, although in Canada the ratio of family physicians to pediatricians is six times that in the United States, and Canadian specialists are concentrated in urban centres. This means that family physicians will continue to provide most of the child care in Canada and need adequate training. They also need to develop cooperative, supportive relationships with specialists in child health care to enhance appropriate referral patterns.
1983 - 1984年进行的一项调查重点关注了加拿大医学院校的儿科学系在儿童护理培训方面是否以及在多大程度上与家庭医学系展开合作。向各系主任发放的调查问卷的回复表明，总体而言，最具支持性的关系存在于西部省份，从西向东发现的问题逐渐增多。关于儿科医生和家庭医生角色的回复也呈现出这一趋势，西部的观点认为儿科医生是初级保健的顾问而非竞争对手。许多受访者支持扩大家庭医学，尤其是在门诊和行为领域。这些数据引发了对儿童未来医疗保健的一些担忧，因为预计医生供应过剩可能会促使这两个群体之间产生竞争而非协作。此外，许多加拿大儿科医生接受包括初级保健在内的美国儿科学模式，尽管在加拿大，家庭医生与儿科医生的比例是美国的六倍，而且加拿大的专科医生集中在城市中心。这意味着家庭医生将继续在加拿大提供大部分儿童护理服务，他们需要充分的培训。他们还需要与儿童医疗保健领域的专科医生建立合作、支持性的关系，以改善合理的转诊模式。
