從美國醫師調查反思台灣醫療環境現況（from 台灣醫界 Apr 2013）

[chienchun]

從美國醫師調查反思台灣醫療環境現況
http://www.tma.tw/ltk/102560412.pdf

[gary]

太艱深了
一般民眾不會有感

[newshine]

好文章

[李誠民]

Service: An Essential Component of Graduate Medical Education
Jennifer C. Kesselheim, M.D., M.Ed., and Christine K. Cassel, M.D., M.A.C.P.
N Engl J Med 2013; 368:500-501February 7, 2013DOI: 10.1056/NEJMp1214850

Medicine is a service profession, and commitment to service is a hallmark of humanistic人性的 人文主義 physicians.......
Though fundamental to physicians' professional role, service is being harmfully undermined within the medical profession and within graduate medical education (GME) in particular.....
Whereas medical students pay tuition教學 學費 for their education, residents continue to learn while becoming an invaluable part of an institution's workforce. Residents are trainees who are evolving into autonomous practicing physicians — a process that requires balancing the responsibility of educating oneself with responsibility for direct patient care. During this evolution, residents must focus on both education and service....
But the ACGME survey raises numerous unanswered questions. Is it appropriate to focus on residents' personal interpretations of the terms “service” and “education”? How do residents define service? Does their definition align with those used by practicing clinicians and experienced educators (or by the Arnold P. Gold Foundation)
.........As we train future physicians, we should convey the message that service to patients is fundamental to our professional role and an invaluable mechanism for learning.

The 2011 Duty-Hour Requirements — A Survey of Residency Program Directors
N Engl J Med 2013; 368:694-697February 21, 2013DOI: 10.1056/NEJMp1214483
In 2010, the Accreditation Council for Graduate Medical Education (ACGME) released new Common Program Requirements designed to improve patient safety as well as resident education and quality of life
program directors supported the 80-hour workweek, the maximum frequency of in-house call, and mandatory off-duty time, they opposed limiting first-year residents to 16-hour shifts
.......most important finding is the strongly negative response to the 16-hour shift limitation for first-year residents, which mirrors that of earlier surveys.2-4 As the most junior physicians in the hospital, interns may be the most susceptible to fatigue and errors due to inexperience. Yet residents and program directors do not report that interns are less fatigued or working fewer total hours.

ACGM將Intern(PGY-1最被壓榨的基層醫師(?Training)改為限制16 hrs.以上才可輪值;;但並未增加Intern 休息時間,最後IOM的結論(?),要到2014年發表;;;
等著吧!!!

[李誠民]

Service: An Essential Component of Graduate Medical Education
Jennifer C. Kesselheim, M.D., M.Ed., and Christine K. Cassel, M.D., M.A.C.P.
N Engl J Med 2013; 368:500-501February 7, 2013DOI: 10.1056/NEJMp1214850

Medicine is a service profession, and commitment to service is a hallmark of humanistic人性的 人文主義 physicians.......
Though fundamental to physicians' professional role, service is being harmfully undermined within the medical profession and within graduate medical education (GME) in particular.....
Whereas medical students pay tuition教學 學費 for their education, residents continue to learn while becoming an invaluable part of an institution's workforce. Residents are trainees who are evolving into autonomous practicing physicians — a process that requires balancing the responsibility of educating oneself with responsibility for direct patient care. During this evolution, residents must focus on both education and service....
But the ACGME survey raises numerous unanswered questions. Is it appropriate to focus on residents' personal interpretations of the terms “service” and “education”? How do residents define service? Does their definition align with those used by practicing clinicians and experienced educators (or by the Arnold P. Gold Foundation)
.........As we train future physicians, we should convey the message that service to patients is fundamental to our professional role and an invaluable mechanism for learning.

The 2011 Duty-Hour Requirements — A Survey of Residency Program Directors
N Engl J Med 2013; 368:694-697February 21, 2013DOI: 10.1056/NEJMp1214483
In 2010, the Accreditation Council for Graduate Medical Education (ACGME) released new Common Program Requirements designed to improve patient safety as well as resident education and quality of life
program directors supported the 80-hour workweek, the maximum frequency of in-house call, and mandatory off-duty time, they opposed limiting first-year residents to 16-hour shifts
.......most important finding is the strongly negative response to the 16-hour shift limitation for first-year residents, which mirrors that of earlier surveys.2-4 As the most junior physicians in the hospital, interns may be the most susceptible to fatigue and errors due to inexperience. Yet residents and program directors do not report that interns are less fatigued or working fewer total hours.

ACGM將Intern(PGY-1最被壓榨的基層醫師(?Training)改為限制16 hrs.以上才可輪值;;但並未增加Intern 休息時間,最後IOM的結論(?),要到2014年發表;;;
等著吧!!!