Physician discontent - Challenges and opportunities
Physician discontent - Challenges and opportunities
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DOI：
10.1001/jama.290.7.941
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发表时间：
2003-08-20
影响因子：
120.7
通讯作者：
Mechanic, D
中科院分区：
文献类型：
--
作者：
Mechanic, D
大多数医生继续报告整体职业满意度，但公众和患者的期望以及行政和监管控制的增加有助于增加时间压力和自主权的侵蚀。越来越多的知识渊博的患者从媒体上获得信息，以及健康计划、政府、专业协会、专业组织和倡导团体制定的指南，使医生面临一系列令人困惑的新期望和要求。虽然医生花在病人身上的时间比以前多了，但他们觉得自己在跑步机上。缓解压力的策略包括增加使用和扩大非医生临床医生的范围，采用信息技术和疾病管理计划，以减少错误，提高效率和质量，以及周到的实践设计。使用这些策略，结合领导力和明确的方向感，可以增强医生的能力，为他们提供扩展的知识和专家系统，并减轻一些实践负担和挫折感。
Most physicians continue to report overall career satisfaction, but increased public and patient expectations and administrative and regulatory controls contribute to perceptions of increased time pressures and erosion of autonomy. Increasingly, knowledgeable patients armed with information from the media, as well as guidelines developed by health plans, government, specialty societies, professional organizations, and advocacy groups, confront physicians with a bewildering array of new expectations and demands. Although physicians are spending more time with patients than in earlier periods they feel themselves on a treadmill. Strategies to ease pressures include increased use and enhanced scope of nonphysician clinicians, adoption of information technology and disease management programs to reduce errors and to increase efficiency and quality, and thoughtful practice design. Use of such strategies, combined with leadership and a clear sense of direction, can empower physicians, provide them with expanded knowledge and expert systems, and relieve some practice burdens and frustrations.