Rabin D L
J Community Health. 1981 Summer;6(4):237-45. doi: 10.1007/BF01324000.
Review of national programs in the past decade suggests that there is a developing consensus regarding the need for preventive services, but the proportion of them that physicians provide is decreasing. As teachers of preventive medicine, we should have a particular concern with the physician's performance in providing preventive services. Specialization, practice organizations, and comprehensiveness of payment ofr medical care appear to be related to the volume of preventive services provided. Organized primary care practice sites, where other health professionals are available, seem especially well-suited to providing preventive services. A review of several effective preventive activities involving physicians (child and adult immunizations, early detection and treatment of PKU infants, and stroke prevention) indicates that current prevention practice is less than desirable. Better performance can be attained through successful national and community programs of consumer and physician education. Implications of these observations for medical undergraduate and graduate education in prevention are discussed.
对过去十年国家项目的回顾表明，对于预防服务的必要性已逐渐形成共识，但医生提供这些服务的比例却在下降。作为预防医学教师，我们应特别关注医生在提供预防服务方面的表现。医疗保健的专业化、执业机构以及支付的全面性似乎与所提供的预防服务量相关。有其他健康专业人员参与的有组织的初级保健执业场所似乎特别适合提供预防服务。对几项涉及医生的有效预防活动（儿童和成人免疫接种、苯丙酮尿症婴儿的早期检测和治疗以及中风预防）的回顾表明，当前的预防实践并不理想。通过成功的全国性和社区性消费者及医生教育项目可以取得更好的成效。文中还讨论了这些观察结果对医学本科和研究生预防教育的启示。
