Horner J S
J Epidemiol Community Health. 1980 Jun;34(2):69-75. doi: 10.1136/jech.34.2.69.
The development of community medicine is seen in historical perspective and found to be a redirection of preceding trends rather than the development of new concepts. The current problems of the specialty are reviewed and found to be due to erroneous perceptions of its role by many doctors, to the specialty's present preoccupation with its academic purity, and to the failure to provide within the National Health Service the resources that were vital to the functions it was asked to perform. It is argued that the essential skill of community physicians is epidemiology, which must be applied within the management process of the National Health Service to enable it to adapt itself to the needs of changing disease patterns. It must also be applied to the prevention of disease and this will necessarily involve the community physician in much wider social problems than the provision of medical care services. This second responsibility may well prove to be the more crucial in the longer term.
从历史角度审视社区医学的发展，会发现它是对先前趋势的重新定向，而非新概念的发展。本文回顾了该专业当前存在的问题，发现这些问题源于许多医生对其角色的错误认知、该专业目前对学术纯粹性的执着，以及未能在国民医疗服务体系中提供对其履行所要求职能至关重要的资源。有人认为，社区医生的基本技能是流行病学，必须将其应用于国民医疗服务体系的管理过程中，以使该体系能够适应不断变化的疾病模式。它还必须应用于疾病预防，这必然会使社区医生涉及比提供医疗服务更广泛的社会问题。从长远来看，这第二项职责很可能被证明更为关键。
