Comparison and implication of general practice system in China and Australia
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摘要: 目的 通过实地考察澳大利亚全科医学体系的实际情况,并与国内全科医学现状进行比较,为我国全科医学的发展提出了新的理念和措施,以期发挥借鉴和参考作用。 方法 派遣一名全科医学的在读硕士及一名已参加社区卫生服务工作的全科规范化培养已毕业学员,在澳大利亚悉尼大学参加为期7周的全科医学强化学习和实地考察,内容包括参加全科学术讲座、澳大利亚皇家全科医师协会参观、全科医学诊所见习、参观综合医院及护理院、参观医学生全科专业课程及考核等方式,比较分析澳大利亚和中国全科医学体系的异同。 结果 中国和澳大利亚全科医学在分级诊疗中扮演的角色、全科医学人才培养模式、全科医师自我认同、晋升途径及相关职业考核制度等方面存在差异。 结论 在我国目前全科医学发展的基础上,进一步完善转诊的程序、加强全科医师与专科医师之间的联系、加强全科医师与养老院之间的合作、增加综合医院全科门诊的比重、在临床专业本科期间开始全科医学专业课程、加强医患沟通能力的培养、学习并借鉴澳大利亚全科的诊疗思维、丰富课堂及见习中的教学模式、科学调整医疗保险考核的指标、优化医师晋升制度、鼓励全科医师参与合作型科研计划、进一步推进多点执业、鼓励优秀医师主动选择全科医学专业方向。Abstract: Objective To put forward new ideas and measures after field investigation for the actual situation of the Australian general practice system and compare with our present practice for insights and reference. Methods A postgraduate and a graduate of the standardized training of general practitioners who was working in Community Health Service were sent to attend field trip and intensive learning about general practice for 7 weeks in the University of Sydney, who attended general practice academic lectures, visited the Royal Australian College of General Practitioners, apprenticed in general practice clinics, visited the hospital and nursing home and observed medical students' general practice professional courses and assessments. Then we compared and analyzed the similarities and differences between Chinese and Australian general practice systems. Results There are some differences of general practice between China and Australia in aspects of the role of general practice in hierarchical medical system, personnel training mode of general practice, self-identification and career path of general practitioner and system of exam and assessment. Conclusion It needs to further improve the referral procedures, intensify the connection between the general practitioner and the specialist, and strengthen the cooperation between the general practitioner and the nursing home, increase the proportion of general clinic services in hospitals, set up general practice course during the undergraduate, strengthen the training of doctor-patient communication ability, learn the thinking of diagnosis and treatment from the Australian general department, enrich the teaching model in class and probation, adjust the evaluation index of medical insurance scientifically, optimize the promotion system, encourage general practitioners to participate in collaborative research projects, further promote multi-site practice and encourage excellent doctors to choose general practice proactively on the basis of the development of general practice in China.
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Key words:
- General practice /
- China /
- Australia /
- Talent training
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