某社区卫生服务中心全科医师外科操作能力培养的探讨

Discussion on Cultivation of Surgical Operation Ability of General Practitioners in a Community Health Service Center

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相关内容于一体的综合性医学专业学科,涉及内科、外科、妇科、儿科等,面向社区与家庭,强调以人为中心、以家庭为单位、以社区为范围。全科医师工作除了为社区居民提供基本的医疗服务以外,还提供保健、预防、康复、健康教育等基本卫生服务,旨在给予患者长期综合性、负责式照顾。随着以基层为重点的分级诊疗服务体系的医疗改革推进,人们对全科医师外科操作能力的需求日益增加,在社区卫生服务中心门诊开展外科操作可以为社区居民提供外科方面的医疗服务。然而,目前对于社区全科医师临床能力的培养偏重于慢性病的规范诊治,对外科操作能力的重视程度相对不足。该文以上海市奉贤区奉浦街道社区卫生服务中心为例,探讨了社区全科医师外科操作能力不足的原因,并提出培养方法,包括合理设置岗位、建立完善的培训机制、制定合理的培训内容和操作标准、创新全科实习医生教学方法、增加科室间交流、利用好教学平台、持续自我培养、适当评价,旨在提高全科医师外科操作能力,为患者提供更好的医疗服务。

General medicine is a comprehensive medical professional discipline integrating clinical medicine,preventive medicine,rehabilitation medicine and humanities and social disciplines,involving internal medicine,surgery,gynecology,pediatrics,etc.It is oriented to community and family,emphasizing people-oriented,family as a unit,and community as a scope.In addition to providing basic medical services for community residents,general practitioners also provide basic health services such as health care,prevention,rehabilitation and health education,aiming at providing patients with long-term comprehensive and responsible care.With the advancement of the medical reform of the hierarchical diagnosis and treatment service system focusing on the grassroots,people's demand for the surgical operation ability of general practitioners is increasing day by day.The surgical operation carried out in the outpatient department of community health service center can provide surgical medical services for community residents.However,at present,the cultivation of clinical competence of community general practitioners focuses on the standardized diagnosis and treatment of chronic diseases,and pays less attention to the surgical operation ability.Taking Shanghai Fengxian District Fengpu Street Community Health Service Center as an example,this paper probed into the causes of inadequate surgical operation ability of community general practitioners.This paper also proposed training methods,including reasonable post setting,perfect training mechanism,reasonable training content and operating standards,innovative teaching methods for general practice doctors,increasing inter-department communication,making good use of teaching platforms,continuous self-training,and appropriate evaluation,in order to improve the surgical operation ability of general practitioners and provide better medical services for patients.