Francisco G E, Chae J C, DeLisa J A
Department of Physical Medicine and Rehabilitation, UMD-New Jersey Medical School, Newark, New Jersey 07103, USA.
Am J Phys Med Rehabil. 1995 May-Jun;74(3):186-92. doi: 10.1097/00002060-199505000-00002.
The ongoing changes in health care seek to create an affordable, accessible, and high-quality health care delivery system for all Americans. In response to this, Physical Medicine and Rehabilitation (PM&R) is re-examining its role in the provision of health care to the disabled, particularly the severely affected. We surveyed 100 physiatrists and 100 PM&R residents across the country regarding their opinions on the competence, qualifications, and desire of physiatrists to provide primary care for the disabled. Fifty-five physiatrists and 51 residents responded (55% overall). Thirty-nine percent of all respondents agreed that PM&R should be designated as a primary care specialty, and 53% believed that physiatrists should provide primary care to the severely disabled (e.g., spinal cord and head injury). Overall, 53% felt that physiatrists are competent in general medical care, but 38% are convinced that the current 4-yr PM&R residency training sufficiently prepares physiatrists to assume the role of a primary care provider. Of the patient populations considered, the respondents thought that physiatrists should manage the care of spinal cord injury (60%) and head injury (51%), but only 40% were willing to assume primary care responsibilities.
当前医疗保健领域的变革旨在为所有美国人创建一个负担得起、可及且高质量的医疗服务提供系统。对此，物理医学与康复医学（PM&R）正在重新审视其在为残疾人，尤其是重度残疾人提供医疗保健方面的作用。我们就物理治疗师为残疾人提供初级保健的能力、资质及意愿，对全国100名物理治疗师和100名物理医学与康复医学住院医师进行了调查。55名物理治疗师和51名住院医师做出了回应（总体回应率为55%）。所有受访者中有39%同意应将物理医学与康复医学指定为初级保健专科，53%认为物理治疗师应为重度残疾人（如脊髓损伤和头部损伤患者）提供初级保健。总体而言，53%的人认为物理治疗师具备一般医疗护理能力，但38%的人确信目前为期4年的物理医学与康复医学住院医师培训足以让物理治疗师承担起初级保健提供者的角色。在考虑的患者群体中，受访者认为物理治疗师应负责脊髓损伤患者（60%）和头部损伤患者（51%）的护理，但只有40%愿意承担初级保健责任。
