Smith C B
Department of Medicine, University of Washington School of Medicine, Seattle, USA.
West J Med. 1997 Dec;167(6):420-5.
In the past four years, the Department of Veterans Affairs (VA) has experienced unprecedented changes in the ways it provides medical care, trains medical residents, and supports its clinical research program. For the most part, these changes have improved the quality and efficiency of care provided to veterans, and they have improved the chances that the VA will survive in an increasingly competitive medical market place. While the changes in priorities for training medical residents and funding clinical research have been designed to be more consistent with the overall mission of the VA, these changes have been stressful for many of the VA/medical school affiliations. Our challenge is to understand and manage these changes so that the many benefits that have derived from more than fifty years of VA/medical school affiliations can be retained.
在过去四年里,退伍军人事务部(VA)在提供医疗护理、培训住院医师以及支持其临床研究项目的方式上经历了前所未有的变革。在很大程度上,这些变革提升了为退伍军人提供的护理质量和效率,也增加了退伍军人事务部在竞争日益激烈的医疗市场中生存下去的机会。虽然调整住院医师培训重点和临床研究资金投入的目的是使其更符合退伍军人事务部的总体使命,但这些变革给许多退伍军人事务部与医学院的合作关系带来了压力。我们面临的挑战是理解并应对这些变革,以便保留五十多年来退伍军人事务部与医学院合作所带来的诸多益处。