Kizer K W, Norby R B
Department of Veterans Affairs, Washington, DC 20420, USA.
J Allied Health. 1998 Fall-Winter;27(4):183-7.
As a consequence of the re-engineering of the veterans healthcare system initiated in 1995, non-physician clinicians are functioning with new levels of autonomy and expanded scopes of practice, but they are not consistently being utilized to their optimal potential. A work group appointed by the Under Secretary of Health in 1996 found various barriers to improving this situation: 1) lack of clarity regarding the roles of the non-physician clinicians; 2) lack of understanding of the basis of their credentialing; 3) lack of uniformity of their credentials; 4) non-acceptance by physicians and managers; 5) rigidity of administrative policies; and 6) salary, benefit, and career-advancement issues. The authors recommend ongoing management attention to addressing these barriers both within and outside the VHA system.
由于1995年启动的退伍军人医疗系统的重新设计，非医师临床医生正以新的自主水平开展工作，并且执业范围有所扩大，但他们并未始终得到充分利用以发挥其最佳潜力。1996年由卫生部副部长任命的一个工作组发现了改善这种状况的各种障碍：1）非医师临床医生的角色缺乏明确性；2）对其资质认定依据缺乏了解；3）其资质缺乏统一性；4）未被医生和管理人员接受；5）行政政策僵化；以及6）薪资、福利和职业发展问题。作者建议退伍军人健康管理局（VHA）系统内外的管理层持续关注解决这些障碍。
