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回到未来:呼吁精神病学走向全科化。

Back to the future: A call to generalism in psychiatry.

作者信息

Coleman Mathew, Cuesta-Briand Beatriz

机构信息

The Rural Clinical School of WA, University of Western Australia, Crawley, WA, Australia.

WA Country Health Service, Geraldton, WA, Australia.

出版信息

Australas Psychiatry. 2025 Aug;33(4):697-702. doi: 10.1177/10398562251351507. Epub 2025 Jun 16.

DOI:10.1177/10398562251351507
PMID:40522752
Abstract

IntroductionProviding a sustainably resourced medical workforce to meet the healthcare needs of a population is a significant challenge. Drivers of medical workforce issues include an ageing population, increasing chronic disease, skill shortages and workforce maldistribution. In this paper, we consider the imbalance between generalism and specialism in Australia, arguing that generalist positions may better address the current healthcare gaps.Analysis and evidenceWe describe generalism in the broad Australian healthcare system before exploring generalism within psychiatry and reflect on how lessons learned in rural generalist psychiatry can be applied to broader medical workforce reform.DiscussionThe imbalance between specialism and generalism within the mental health workforce across settings must be re-examined given the increased burden of disease and patient complexity. An explicit articulation and recognition of generalism within psychiatry may yield positive results on workforce development and ultimately accessibility of psychiatric services across geographical and service delivery settings.ConclusionAdvocating for generalist psychiatry, alongside general practice, to be at the centre of workforce solutions into the future is more critical than ever. The profession must give generalist psychiatry the recognition it deserves, lift its professional status and prioritise its training before we lose our authority and our social licence.

摘要

引言

提供一支资源可持续的医疗劳动力队伍以满足人群的医疗保健需求是一项重大挑战。医疗劳动力问题的驱动因素包括人口老龄化、慢性病增加、技能短缺和劳动力分布不均。在本文中,我们探讨了澳大利亚通科医疗与专科医疗之间的失衡,认为通科医疗岗位可能更有助于解决当前的医疗保健差距。

分析与证据

我们先在澳大利亚广泛的医疗体系中描述通科医疗,然后探讨精神病学领域的通科医疗,并思考农村通科精神病学的经验教训如何应用于更广泛的医疗劳动力改革。

讨论

鉴于疾病负担增加和患者情况复杂,必须重新审视不同环境下心理健康劳动力中通科医疗与专科医疗之间的失衡。明确阐述并认可精神病学领域的通科医疗可能会对劳动力发展以及最终跨地理区域和服务提供环境的精神科服务可及性产生积极影响。

结论

倡导通科精神病学与全科医疗一样,成为未来劳动力解决方案的核心,这比以往任何时候都更加关键。在我们失去权威和社会认可之前,该专业必须给予通科精神病学应有的认可,提升其专业地位并优先考虑其培训。

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