"THE BLINDNESS OF THOSE WHO WILL NOT SEE: ON THE REPLACEMENT OF PRIMARY CARE DOCTORS IN THE 21ST CENTURY. A response to Timmermans".
"THE BLINDNESS OF THOSE WHO WILL NOT SEE: ON THE REPLACEMENT OF PRIMARY CARE DOCTORS IN THE 21ST CENTURY. A response to Timmermans".
复制标题
DOI：
10.1016/j.socscimed.2008.07.014
复制
发表时间：
2008-11
影响因子：
5.4
通讯作者：
McKinlay, John B.
中科院分区：
文献类型：
--
作者：
Marceau, Lisa;McKinlay, John B.
It is hard to figure out what motivated the comments on our paper “When There is no Doctor…”(McKinlay and Marceau, 2008), since Timmermans begins by characterizing our thesis as “bleak futurama,” proceeds to generally agree with much of our evidence and arguments and then concludes in almost complete agreement (Timmermans, 2008). He summarizes our essential position when he states,“They envision a world without primary care physicians but not necessarily without primary care.” We outlined seven reasons why primary care doctors are an endangered species, likely to be largely extinct by about 2025. We argue there will a continuing and likely increasing need for effective primary care, especially with a rapidly aging population and increasing co-morbidities, but this is unlikely to be provided by doctors. Social structural influences will drive them from the medical playing field (in contrast to their voluntarily “skipping town”) and they will be replaced by: a) eventually cheaper and equally effective health care workers (especially appropriately trained nurses), b) virtual visits on the internet (web visits), and c) specialists who replace primary care doctors and are part of the “hidden system of primary care”(Timmermans, 2008, PAGE REF NEEDED)(doctors trained as specialists who also provide general primary care to their patients). Admittedly, we gave insufficient emphasis to this phenomenon, even though it supports our general argument.We deliberately offer no judgment as to whether the likely disappearance of primary care doctors is a good or bad development–that requires careful consideration of the demonstrated effectiveness (preferably by randomized controlled trial) of doctors versus other types of delivery, say by nurses, specialists or even a computer. Lacking the requisite data we do not comment on whether the “the retreat of physicians is a loss for primary care.”(Timmermans, 2008, PAGE REF NEEDED)
登录
查看更多内容
影响因子：
3.4
作者：
FREIDSON, E
通讯作者：
FREIDSON, E
影响因子：
6.6
作者：
HAFFERTY, FW
通讯作者：
HAFFERTY, FW
影响因子：
12.7
作者：
Shi, LY;Starfield, B
通讯作者：
Starfield, B
影响因子：
3.4
作者：
Macinko, James;Starfield, Barbara;Shi, Leiyu
通讯作者：
Shi, Leiyu
影响因子：
3.4
作者：
MCKINLAY, JB
通讯作者：
MCKINLAY, JB