Schuman S H, Mohr L J, Simpson W M
Department of Family Medicine, Medical University of South Carolina, Charleston 29425, USA.
J Occup Environ Med. 1997 Dec;39(12):1191-4. doi: 10.1097/00043764-199712000-00013.
A four-prototype approach to the occupational and environmental medicine (OEM) patient in a busy primary care setting is described. A 2 x 2 table illustrates the two diagnostic, interrelated tasks during the outpatient, non-urgent visit: (a) sick? yes/no, and (b) exposed? yes/no. One may have the basic skills for task (a) but feel insecure for task (b). With OEM experience, creative use of resources (databases and consultants), and patient cooperation, a better balance between task (a) and task (b) can be achieved. The Environmental Medicine Curriculum Committee (EMCC) initiative described in Part I and Part II of this study has developed this patient-centered model to help the resident in training cope as he or she tries to deal with emerging patient concerns from the workplace and beyond. In November 1996, an expert panel of consultants representing OEM, public health, and family medicine endorsed the prototype OEM patient model for further development.
本文介绍了一种针对繁忙基层医疗环境中职业与环境医学（OEM）患者的四原型方法。一个2×2表格展示了门诊非紧急就诊期间两项相互关联的诊断任务：（a）患病？是/否，以及（b）暴露？是/否。有人可能具备完成任务（a）的基本技能，但对任务（b）感到不自信。通过OEM经验、创造性地利用资源（数据库和顾问）以及患者的配合，可以在任务（a）和任务（b）之间实现更好的平衡。本研究第一部分和第二部分中描述的环境医学课程委员会（EMCC）倡议开发了这种以患者为中心的模型，以帮助住院医师在培训过程中应对来自工作场所及其他方面新出现的患者问题。1996年11月，一个由代表OEM、公共卫生和家庭医学的顾问组成的专家小组认可了OEM患者原型模型，以便进一步开发。
