Schatz I J, Realini J P, Charney E
Department of Medicine, University of Hawaii John A. Burns School of Medicine, Honolulu 96813, USA.
Acad Med. 1996 Jan;71(1):35-9. doi: 10.1097/00001888-199601000-00015.
The generalist of the future will play an integral role in the health care delivery system, yet the three recognized generalist specialties have developed and functioned along largely separate tracks. No matter what form of generalism evolves, family practice, internal medicine, and pediatrics must begin to cooperate and collaborate in developing new graduate medical education programs that are sufficiently flexible to meet whatever emerges in the future. They must devote their energies to working together, rather than competing; to emphasizing those parts of their programs that have similarities; and to sharing their knowledge, skills, attitudes, and perspectives about the care of patients. They must develop training experiences in which residents will obtain maximum contact with a wide variety of problems and patients in many different settings; a substantial portion of such training should be generic and virtually interchangeable among the three specialties. As the health care system evolves, so should these disciplines; they must begin to "train physicians to provide continuing, comprehensive and coordinated medical care to a population undifferentiated by gender, disease or organ system," as urged by the American Boards of Family Practice and Internal Medicine.
未来的全科医生将在医疗服务体系中发挥不可或缺的作用，然而，三个公认的全科医学专业在很大程度上是沿着各自独立的轨道发展和运作的。无论全科医学发展成何种形式，家庭医学、内科医学和儿科学都必须开始合作，共同开发新的毕业后医学教育项目，这些项目要足够灵活，以应对未来出现的任何情况。它们必须致力于共同努力，而非相互竞争；强调各自项目中具有相似性的部分；分享关于患者护理的知识、技能、态度和观点。它们必须开展培训活动，让住院医师能够在多种不同环境中最大限度地接触各种各样的问题和患者；此类培训的很大一部分应该是通用的，并且在这三个专业之间几乎可以互换。随着医疗体系的发展，这些学科也应如此；正如美国家庭医学委员会和内科医学委员会所敦促的那样，它们必须开始“培养医生，以便为不分性别、疾病或器官系统的人群提供持续、全面和协调的医疗服务”。
