目的 探讨在家庭医生签约和家庭医生责任制政策背景与服务模式下, 中医全科医生参与家庭医生服务的优势、不足和改进措施.方法 以实际工作经历为基础, 梳理担任家庭医生一年来开展工作的内容、方式、完成的工作总量以及自我和患者对已完成家庭医生工作的评价.结果 中医全科医生在家庭医生责任制服务模式中, 家庭医生服务量较高, 基本医疗服务量和公共卫生服务量较低;自我评价工作量过大、对新工作方式经验不足和服务中没有展现出中医理念优势和技术优势;患者评价对服务内容满意, 对服务便利性敏感, 体现在较远的获得服务半径极大地减少了到诊率.结论 在当前家庭医生服务人少事多的阶段, 中医全科治未病和辨证论治理念因为没有时间、缺乏与个性化服务相匹配的绩效考核方式, 未能落实到家庭医生健康管理和公共卫生服务的实践中.建议:改变单兵作战模式, 推广"一医一护"协同, 注重家庭医生服务岗前培训和提供与个性化服务相对应的绩效考核方案, 将有望加快家庭医生服务的落实和更早地发挥中医药的理念优势和技术优势.%OBJECTIVE To explore the advantages, disadvantages and improvement measures of Chinese medicine general practitioners participating in family doctor service under the policy background and service mode of family doctor contract signing and family doctor responsibility system. METHODS Based on the practical experience, the work content, the way to carry out the work, the total amount of work completed, the self-evaluation and the patients' evaluation of the completed work of the family doctor were sorted out. RESULTS Compared with the general practitioners of Western medicine, the general practitioners of traditional Chinese medicine (TCM) had higher service quantity of family doctors, lower basic medical service quantity and public health service quantity in the service mode of family doctors' responsibility system;the self-evaluation workload of TCM general practitioners was too heavy, the experience of new working methods was insufficient, and the advantages of TCM concept and service were not shown. Patient evaluation was satisfied with the service content and sensitive to service convenience, which reflected in the far radius of service greatly reduced the attendance rate. CONCLUSION At present, the family doctor's service personnel were few and multi-stage, the concept of general practice and dialectical management of traditional Chinese medicine could not be implemented into the practice of family doctor's health management and public health service because of lack of time and performance appraisal method matching with personalized service. Promoting "one doctor, one nurse" collaboration, focusing on pre-job training of family doctor services, and providing performance appraisal programs corresponding to personalized services would hopefully speed up the implementation of family doctor services, and give full play to the conceptual and technical advantages of TCM.
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