Marsh G N
Br Med J. 1971 Feb 6;1(5744):339-41. doi: 10.1136/bmj.1.5744.339.
The Canadian general practitioner is remunerated by an item-of-service system of payment which encourages servicing demands rather than needs, discourages delegation of work to paramedical workers, and involves his staff in a massive amount of paper work. He has an excellent hospital attachment, which unfortunately is overdone. His community facilities are piecemeal and his office organization is rudimentary. There are few incentives for good general practice in the community. He spends an inordinate amount of time examining well people. The university departments of general practice are extremely good and much should be heard from them very quickly. The patient's attitude towards his doctor is quite different from the one prevailing currently in Britain.I returned happily to British general practice.
加拿大的全科医生通过按服务项目付费系统获得报酬,这一系统鼓励满足服务需求而非实际需求,不鼓励将工作委托给辅助医疗人员,还让其工作人员陷入大量文书工作。他与医院联系紧密,这一点很好,但不幸的是有些过度。他所在社区的设施零零散散,办公室组织也很简陋。社区中几乎没有激励措施促使人们做好全科医疗服务。他花费过多时间为健康的人做检查。大学的全科医学系非常出色,应该尽快多听听他们的意见。患者对医生的态度与目前英国普遍存在的态度截然不同。我很高兴回到了英国的全科医疗工作中。