浅谈全科医生的临床哲学思维

马万瑞; 任菁菁; 王志忠

doi:10.16766/j.cnki.issn.1674-4152.003657

浅谈全科医生的临床哲学思维

doi: 10.16766/j.cnki.issn.1674-4152.003657

1.
广东医科大学附属东莞第一医院全科医学科，广东东莞 523710
2.
浙江大学医学院附属第一医院全科医疗科，浙江杭州 310003
3.
广东医科大学公共卫生学院，广东东莞 523808

基金项目:

国家自然科学基金项目 81860599

广东医科大学附属东莞第一医院高层次人才科研资助计划项目 GCC2023003

详细信息

通讯作者:
王志忠，E-mail：wzhzh_lion@126.com

中图分类号: R499 R192.3
计量
- 文章访问数: 90
- HTML全文浏览量: 57
- PDF下载量: 133
- 被引次数: 0
出版历程
- 收稿日期: 2023-05-06

Discussion on clinical philosophical thinking of general practitioners

1.
Department of General Practice, the First Dongguan Affiliated Hospital, Guangdong Medical University, Dongguan, Guangdong 523710, China

摘要

摘要: 全科医学是整合临床医学、预防医学、康复医学以及人文社会学科等于一体的综合性医学专业学科，加之全科医学的主要诊疗范围具有特殊性和复杂性，这都要求全科医生除了具有高度的责任心、综合性的专业知识、丰富的生活经验、执着的科学精神和卓越的管理才能之外，还要学会自觉地建立并科学应用哲学的思维方法。早在2 400多年前，古希腊医学家希波克拉底就提出：“医学家必须同时是哲学家”。世界医学会在《日内瓦宣言》中也倡议，医生应当具备哲学家的全部最好品质。全科医生更是如此，哲学思维可以帮助其在临床工作中改变思维的主观性、片面性、表面性和静止性，亦是当前生物-心理-社会医学模式的体现，也能使全科医生保持良好的人文修养、具备处理各种问题的本领与艺术。因此，全科医生临床哲学思维的培养，对全科医生的临床实践及理论学习都具有重要意义。本文初步探讨全科医学临床思维方法与医学的哲学理念，从理论上浅谈全科医生的临床哲学思维可能对医学实践及教育的作用，为提升全科医生的临床实践能力及教学能力提供一定的参考。
- 全科医学 /
- 全科医生 /
- 哲学思维
Abstract: General practice is an integrative medical discipline that amalgamates clinical medicine, preventive medicine, rehabilitative medicine, and disciplines within the humanities and social sciences. The main diagnosis and treatment scope of general practice has particularity and complexity, which requires general practitioners to learn to consciously establish and scientifically apply philosophical thinking methods in addition to having a high sense of responsibility, comprehensive professional knowledge, rich life experience, persistent scientific spirit, and excellent management skills. More than 2 400 years ago, Hippocrates put it this way: "A physician must be a philosopher at the same time." In the Geneva Declaration, the World Medical Association also advocated that doctors should possess all the best qualities of philosophers. This is especially true for general practitioners. Philosophical thinking can help general practitioners change the subjectivity, one-sidedness, externality, and stillness of their thinking in clinical practices. It is also the embodiment of the current bio-psycho-social medical model, which enables general practitioners to maintain a good humanistic culture and have the ability and art to deal with various problems. Therefore, the cultivation of clinical philosophical thinking of general practitioners is of great significance to the clinical practice and theoretical study of general practitioners. This paper intends to make a preliminary discussion on the clinical thinking method of general medicine and the philosophy of medicine, and theoretically discuss the role that the clinical philosophical thinking of general practitioners may play in medical practice and education, to provide certain references for further improving the clinical practice ability and teaching skills of general practitioners.
- General practice /
- General practitioners /
- Philosophical thinking
利益冲突 无

HTML全文

参考文献(15)

[1]	彭丽, 胡茂子. 利用哲学思维培养全科医生诊治感染性疾病的研究[J]. 现代医药卫生, 2018, 34(8): 1251-1254. PENG L, HU M Z. Study on training general practitioners to diagnose and treat infectious diseases with philosophical thinking[J]. Journal of Modern Medicine & Health, 2018, 34(8): 1251-1254.
[2]	胡大一. 理解医学做合格医生(七)[J]. 中华医学信息导报, 2012, 27(19): 4. HU D Y. Understand medicine and be a qualified doctor[J]. China Medical News, 2012, 27(19): 4.
[3]	任菁菁. 全科常见未分化疾病诊疗手册[M]. 北京: 人民卫生出版社, 2020: 3. REN J J. Manual of diagnosis and treatment of common undifferentiated diseases in general practice[M]. Beijing: People ' s Medical Publishing House, 2020: 3.
[4]	郎景和. 医学与哲学、文学和美学[J]. 中华妇产科杂志, 2021, 56(4): 233-235. LANG J H. Philosophy, literature, aesthetics, and medicine[J]. Chinese Journal of Obstetrics and Gynecology, 2021, 56(4): 233-235.
[5]	祝墡珠, 于晓松, 路孝琴, 等. 全科医学概论[M]. 北京: 人民卫生出版社, 2020: 22. ZHU S Z, YU X S, LU X Q, et al. Introduction to general practice[M]. Beijing: People ' s Medical Publishing House, 2020: 22.
[6]	陈学清, 张万岱. 系统的临床诊断思维[J]. 医学与哲学, 1994, 15(9): 1-3. CHEN X Q, ZHANG W D. Systematic clinical diagnostic thinking[J]. Medicine & Philosophy, 1994, 15(9): 1-3.
[7]	王剑强. 未分化疾病的全科诊疗思维与策略[J]. 中华全科医学, 2023, 21(3): 485-489. doi: 10.16766/j.cnki.issn.1674-4152.002913 WANG J Q. General practice thinking and strategy of diagnosis and treatment of undifferentiated diseases[J]. Chinese Journal of General Practice, 2023, 21(3): 485-489. doi: 10.16766/j.cnki.issn.1674-4152.002913
[8]	何政星, 郎景和. 关于医学与哲学的断想医学的本源与回归[J]. 中华妇产科杂志, 2016, 51(12): 887-889. HE Z X, LANG J H. The origin and return of medicine of thoughts on medicine and philosophy[J]. Chinese Journal of Obstetrics and Gynecology, 2016, 51(12): 887-889.
[9]	徐长顺. 叙事医学的思维方法[J]. 叙事医学, 2023, 6(1): 38, 54. XU C S. The thinking methods of narrative medicine[J]. Narrative Medicine, 2023, 6(1): 38, 54.
[10]	史习, 盛晓明. 客观主义疾病观之殇: 论生物医学视野下的功能概念[J]. 自然辩证法通讯, 2016, 38(3): 137-143. SHI X, SHENG X M. The Failure of Objectivism on the Concept of Disease: From the viewpoint of Biological Medicine[J]. Journal of Dialectics of Nature, 2016, 38(3): 137-143.
[11]	石岩岩, 张华, 陶立元, 等. 医患共同决策的发展及其重要性[J]. 中华儿科杂志, 2017, 55(8): 563. SHI Y Y, ZHANG H, TAO L Y, et al. The development and importance of shared decision making between doctors and patients[J]. Chinese Journal of Pediatrics, 2017, 55(8): 563.
[12]	冯小萌, 邹郁松. 糖尿病患者对医患共同决策辅助工具态度的研究[J]. 医学与哲学, 2021, 42(10): 62-66. FENG X M, ZOU Y S. Diabetic Patients ' Attitudes towards the Patient Decision Aids in Shared Decision-making[J]. Medicine & Philosophy, 2021, 42(10): 62-66.
[13]	叶康丽, 徐志杰, 杜亚平, 等. 应对未分化疾病: 从过度诊断走向医患共同决策[J]. 中国全科医学, 2020, 23(36): 4541-4547. YE K L, XU Z J, DU Y P, et al. Coping with Undifferentiated Diseases: from Over-diagnosis to Shared Decision Making[J]. Chinese General Practice, 2020, 23(36): 4541-4547.
[14]	姜海婷. 直面医学实践挑战, 推进医学哲学研究[J]. 医学与哲学, 2018, 39(1): 95-96. JIANG H T. Facing the challenges of medical practice and promoting the research of medical philosophy[J]. Medicine & Philosophy, 2018, 39(1): 95-96.
[15]	高可音, 史威力, 王留义. 全科医学中的不确定性及管理策略[J]. 中华全科医学, 2024, 22(8): 1267-1269. doi: 10.16766/j.cnki.issn.1674-4152.003614 GAO K Y, SHI W L, WANG L Y. Uncertainty and It's Management Strategies in General Practice[J]. Chinese Journal of General Practice, 2024, 22(8): 1267-1269. doi: 10.16766/j.cnki.issn.1674-4152.003614