Halbert R J, Bokor A, Castrence-Nazareno R, Parkinson M D, Lewis C E
Preventive Medicine Residency, University of California Los Angeles, 90095-1772, USA.
Am J Prev Med. 1998 Jul;15(1):65-70. doi: 10.1016/s0749-3797(98)00020-8.
The evolution of American health care into integrated systems of delivery and finance requires a specialized set of population-based skills for physicians. The field of preventive medicine represents one source of this expertise. Specific competencies for the emerging area of managerial medicine have not been well delineated.
Using concept documents from the Residency Review Committee for Preventive Medicine and the American Board of Preventive Medicine, a list of proposed competencies for managerial medicine was identified. Surveys were mailed to medical directors of all members of the American Association of Health Plans and to a random sample of diplomates of the American Board of Preventive Medicine. Respondents were asked to rate the importance of these competencies for a population-oriented clinician manager.
Areas rated highly by medical directors included health services research (including outcome research), quality assurance and improvement, health risk assessment and reduction, programmatic skills, and clinical preventive skills. Responses from preventive medicine specialists were similar, but placed lower emphasis on these skills.
Despite its limited response rate, this survey may be useful in the implementation of specialty training in managerial medicine. Residency training programs may choose to emphasize specific content area that reflect the priorities expressed by physicians actively involved in management.
美国医疗保健向综合服务与融资体系的演变，要求医生具备一套专门的基于人群的技能。预防医学领域是这一专业知识的来源之一。管理医学这一新兴领域的具体能力尚未得到很好的界定。
利用预防医学住院医师评审委员会和美国预防医学委员会的概念文件，确定了一份管理医学拟议能力清单。向美国健康计划协会所有成员的医疗主任以及美国预防医学委员会的随机抽取的专科医师邮寄了调查问卷。要求受访者对这些能力对于以人群为导向的临床医生管理者的重要性进行评分。
医疗主任高度评价的领域包括卫生服务研究（包括结果研究）、质量保证与改进、健康风险评估与降低、规划技能以及临床预防技能。预防医学专家的回答类似，但对这些技能的重视程度较低。
尽管此次调查的回复率有限，但可能对管理医学专业培训的实施有用。住院医师培训项目可选择强调反映积极参与管理的医生所表达的优先事项的特定内容领域。
