Obstetrics and gynecology at the crossroads—again? Still!: Presidential address☆
Obstetrics and gynecology at the crossroads—again? Still!: Presidential address☆
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妇产科再次处于十字路口？仍然！：总统讲话☆
DOI：
10.1067/mob.2001.115746
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发表时间：
2001
影响因子：
9.8
通讯作者：
R. Sokol
中科院分区：
文献类型：
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作者：
R. Sokol
如果人们相信总统的演讲，似乎我们的专业总是在某个十字路口或其他地方。在这篇“观点文章”中，我没有抱怨管理式医疗。我确实试图找出一些在不久的将来和不那么近的将来对妇产科有重要意义的问题。在研究方面，我们期待着取得突破，例如在卵巢癌的早期发现方面，以便最终能够改善结果。然而，一个问题是，我们未能集中足够的精力培养一批临床科学家，他们可以将研究结果直接应用于临床;这是一个专业需要解决的问题。关于教育，我认为我们需要重新关注我们可能想要培养什么类型的医生，以最好地满足我们病人的需求。最重要的是，在训练方面应更具灵活性，并强调临床能力，以便能够提供具备各种专业能力的优秀医生，为妇女提供全面的适当健康护理。“妇女健康”的概念是有争议的，而且发展迅速。对几个现有资料来源的审查表明，生殖医学仍将是妇女健康的一个重要组成部分，但随着妇女的主要健康问题发生变化，我们的专业现在必须发展到包括其他领域。我们需要从以器官为基础的范式转变为更全面的观点，反映我们专业以女性为中心的重点。这一“范式转变”需要继续提供一流的外科和产科服务，但将扩大到包括全方位的服务，可能由受过高度训练和有能力的具有特定专业领域的个人提供，在多个单一专业小组中执业。妇产科确实处在十字路口！(Am J Obstet Gynecol 2001;184：1313-9.）
Abstract It seems, if one can believe presidential addresses, as if our specialty is always at some crossroads or other. In this “opinion piece,” uniquely, I don’t complain about managed care. I do attempt to identify some of the issues that will be of import for obstetrics and gynecology in the near and not-so-near futures. With regard to research, we await breakthroughs, for example, in the early detection of ovarian cancer, so as to finally be able to improve outcomes. A problem, though, is our failure to focus enough effort on developing a cadre of clinician scientists, who can work out research findings with direct clinical application; this is an issue with which the specialty needs to come to grips. Regarding education, I believe we need to refocus from what type of practitioners we might want to produce to best meet the needs of our patients. The bottom line should be more flexibility in training and emphasis on clinical competence, so that excellent practitioners with competence across the breadth of our specialty are available to provide a full range of appropriate women’s health care. The concept of “women’s health” is controversial and evolving rapidly. Review of several available sources suggests that reproductive medicine will remain an important component of women’s health but that our specialty must now evolve to include other areas, as the major health problems of women change. We need to shift from an organ-based paradigm to a more holistic view, reflecting the woman-centered focus for our specialty. This “paradigm shift” will need to entail continuation of first-rate surgical and obstetrics services but will be expanded to include a full range of services, probably offered by highly trained and competent individuals with specific areas of expertise, practicing in a multi-single-specialty group. Obstetrics and gynecology at the crossroads, indeed! (Am J Obstet Gynecol 2001;184:1313-9.)