中国全科医学

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“大、小、重、慢”疾病定义与全科医生“4善”定位的探讨

李敏, 王仲   

  • 收稿日期:2024-02-01 修回日期:2024-03-07 接受日期:2024-04-03
  • 通讯作者: 王仲

Discussion on the Definition of"Major,Minor,Acute,Chronic" Diseases and the Positioning of "4 Virtues" by General Practitioners

LI Min, WANG Zhong   

  • Received:2024-02-01 Revised:2024-03-07 Accepted:2024-04-03
  • Contact: WANG Zhong
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摘要: 随着我国医疗体系的深度改革,特别是分级诊疗制度的推进,全科医生在基层医疗保健体系中的角色日益显著。全科医生不仅是居民健康的第一道防线,更是常见疾病预防、诊断、治疗及健康教育的关键执行者。国家对全科医生提出了“小病善治、大病善识、重病善转、慢病善管”的临床定位。本文通过分析“小、大、重、慢”疾病的分类与全科医生的“4善”定位,探讨了全科医生在新医改时代下的重要职能及其挑战。作者认为虽然分级诊疗制度旨在优化医疗资源配置,但在实践中仍面临“大、小、重、慢”疾病分类的模糊性和基层医疗资源的不均衡分配等问题。全科医生在这个体系中扮演着至关重要的角色,他们需要具备综合的临床诊疗能力,并与专科医生共同制定临床判断标准和诊疗标准。为了应对这些挑战并充分发挥全科医生在现代医疗体系中的作用,迫切需要对全科医学教育和实践进行进一步的改革与优化,同时强化全科医生的角色定位,以确保在提升医疗服务质量和效率的同时,实现公平和可持续的健康保障体系。

关键词: 全科医生, 分级诊疗, 医疗体系改革, 疾病分类, 医疗资源优化

Abstract: With the deep reform of China's medical system,especially the advancement of the tiered diagnosis and treatment system,the role of general practitioners in the primary healthcare system has become increasingly significant. General practitioners are not only the first line of defense for residents' health,but also key executors of disease prevention,diagnosis,treatment,and health education. This article analyzes the classification of "major,minor,acute,chronic" diseases and the "4 virtues" positioning of general practitioners(namely adept at treating minor illnesses,identifying major illnesses,referring acute illnesses,and managing chronic illnesses),exploring the crucial functions and challenges of general practitioners in the era of new medical reform. The article points out that although the tiered diagnosis and treatment system aims to optimize the allocation of medical resources,it still faces challenges such as the ambiguity of the classification of "major,minor,acute,chronic" diseases and the uneven distribution of primary healthcare resources. General practitioners play a vital role in this system,needing comprehensive clinical diagnostic and treatment capabilities,and to establish clinical judgment standards and treatment protocols in collaboration with specialists. To address these challenges and fully leverage the role of general practitioners in the modern medical system,urgent reforms and optimizations in general medical education and practice are needed,along with strengthening the role of general practitioners,to ensure the improvement of medical service quality and efficiency while achieving a fair and sustainable health security system.

Key words: General practitioners, Hierarchic healthcare, Medical system reform, Disease classification, Medical resource optimization