Primary Care: Proposed Solutions To The Physician Shortage Without Training More Physicians
Primary Care: Proposed Solutions To The Physician Shortage Without Training More Physicians
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DOI：
10.1377/hlthaff.2013.0234
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发表时间：
2013-11-01
期刊：
影响因子：
9.7
通讯作者：
Smith, Mark D.
中科院分区：
文献类型：
--
作者：
Bodenheimer, Thomas S.;Smith, Mark D.
成人初级保健“医生短缺”更准确地描述为成年人口对初级保健服务的需求与目前提供的初级保健满足该需求的能力之间的差距。鉴于目前的趋势，培养更多的成人初级保健临床医生并不能缩小需求与能力之间的差距。然而，初级保健能力可以在不需要更多临床医生的情况下大大提高：通过授权有执照的人员，包括注册护士和药剂师，提供更多的护理；为医疗助理等无证卫生人员制定长期指令，让其充当小组经理和健康教练，以满足许多预防性和慢性护理需求；提高患者自我护理的潜力；并利用技术来增加容量。
The adult primary care "physician shortage" is more accurately portrayed as a gap between the adult population's demand for primary care services and the capacity of primary care, as currently delivered, to meet that demand. Given current trends, producing more adult primary care clinicians will not close the demand-capacity gap. However, primary care capacity can be greatly increased without many more clinicians: by empowering licensed personnel, including registered nurses and pharmacists, to provide more care; by creating standing orders for nonlicensed health personnel, such as medical assistants, to function as panel managers and health coaches to address many preventive and chronic care needs; by increasing the potential for more patient self-care; and by harnessing technology to add capacity.