Redesigning Family Medicine Training to Meet the Emerging Health Care Needs of Patients and Communities: Be the Change We Wish to See
Redesigning Family Medicine Training to Meet the Emerging Health Care Needs of Patients and Communities: Be the Change We Wish to See
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DOI：
10.22454/fammed.2021.897904
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发表时间：
2021-07-01
期刊：
影响因子：
1.9
通讯作者：
Kahn, Norman B., Jr.
中科院分区：
文献类型：
--
作者：
Kahn, Norman B., Jr.
本文反映了如何重新设计家庭医学住院医师培训的愿景，以准备毕业生，以满足其患者群体和区域社区的医疗保健需求。家庭医生需要作为私人医生和患者的日常护理来源，这在历史文献中得到了认可，这些文献将该专业在社会中的持久作用定义为医疗保健系统的基础。现代住院医师实践将包括住院医师作为初级合伙人和多学科教师团队的成员。住院医师的做法将衡量和改善护理符合三重目标：提高护理病人的经验，改善护理人口的结果，并减少浪费和护理系统的成本。课程将包括家庭医生角色的核心要素，包括与患者和家庭建立治疗关系，认识患者的需求和期望，专业精神，急性和慢性疾病的识别和管理，产妇护理以及住院患者的护理。还将包括家庭医生的新期望，包括团队角色，通过远程保健和患者门户网站扩大护理，确定和干预可改变的健康社会决定因素，解决结构性种族主义问题，缩小对患者群体的不公平护理差距，将成瘾作为可治疗的慢性病进行管理，通过临床数据登记、个性化医疗和领导力提高绩效。健康和令人满意的职业保证将是职业生涯长期实践准备的优先重点。居民将成为在实践中需要在多学科团队作为居民所在地区的人口护理的通常来源的连续个人医生的作用服务的全面范围胜任。
This paper reflects a vision of how family medicine residency training will be redesigned to prepare graduates to meet the health care needs of their patient populations and regional communities. Family physicians are needed to serve as personal physicians and as the patient's usual source of care, as recognized in historic documents that have defined the specialty's enduring role in society as the foundation of the health care system.Modern residency practices will include residents as junior partners and members of multidisciplinary faculty teams. Residency practices will measure and improve care consistent with the triple aim: enhancing the experience of care for patients, improving outcomes of care for populations, and reducing waste and the cost of care in the system. Curricula will include core elements of the roles of family physicians, including the development of therapeutic relationships with patients and families, recognizing patients' needs and expectations, professionalism, the identification and management of acute and chronic illness, maternity care, and the care of hospitalized patients.Also included will be emerging expectations of family physicians, including team roles, expanded care through telehealth and patient portals, identifying and intervening in modifiable social determinants of health, addressing structural racism, closing gaps of inequitable care for their patient populations, managing addiction as a treatable chronic illness, improving performance through clinical data registries, personalized medicine, and leadership. Wellness and assurance of a satisfying career will be a priority focus of preparation for career-long practice. Residents will become competent in the comprehensive scope of practice needed to serve in the role of continuous personal physician on multidisciplinary teams that serve as the usual source of care for populations in regions where the residencies are located.