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首页> 外文期刊>Israel Journal of Health Policy Research >Extending the boundaries of family medicine to perform manual procedures
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Extending the boundaries of family medicine to perform manual procedures

机译：扩大家庭医学的范围以执行手动程序

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A recent survey by Menahem and colleagues revealed that 65% of the surveyed primary care physicians reported that they performed any minor surgical procedures, and 46% reported performance of any musculoskeletal injections. Lack of allocated time and lack of training were the main reported barriers confronting higher performance rates. Healthcare systems are shifting large chunks of traditional hospital-centered activities to competent and comprehensive community-based structures. These changes are very well aligned with key trends in modern consumerism that prefer a close to home availability of medical services. Minor surgical procedures and musculoskeletal injections are good examples of medical activities that had been performed mainly by hospital and community based specialists. The syllabus of specialty training in Family Medicine in Israel includes these skills and trainees should acquire them during the residency program. We estimate that hundreds of family physicians obtain different levels of such training. Yet, only few family physicians have allocated protected time for performance of the procedures. For the skilled physician, performance of such relatively simple procedures extends his professional boundaries and the comprehensiveness of his service. For the healthcare system the “extra effort” and investment needed for performance of minor surgical procedures in primary care clinics is small. The results of the present study reflect on wider issues of care delivery. This study highlights the need for formalized and documented training of family physicians together with allocation of managerial and technical requirements needed to encourage these and similar medically and economically justified endeavors that seem to be perfectly aligned with the wishes of healthcare consumers.
机译：Menahem及其同事最近进行的一项调查显示，接受调查的基层医疗医生中有65％的人报告说他们进行过任何次要的外科手术，而46％的人报告了进行过任何肌肉骨骼注射的情况。缺乏分配时间和缺乏培训是提高绩效率面临的主要障碍。医疗保健系统正在将大量传统的以医院为中心的活动转移到胜任且全面的社区基础结构上。这些变化与现代消费主义的主要趋势非常吻合，后者倾向于接近家庭医疗服务。较小的外科手术程序和肌肉骨骼注射是主要由医院和社区专家进行的医疗活动的良好示例。以色列家庭医学专业培训课程包括这些技能，受训人员应在居住计划期间获得这些技能。我们估计数百名家庭医生获得了不同级别的此类培训。但是，只有极少的家庭医生分配了受保护的时间来执行手术。对于熟练的医生来说，执行这种相对简单的程序扩展了他的专业范围和服务的全面性。对于医疗保健系统而言，在初级保健诊所进行小型外科手术所需的“额外努力”和投资很小。本研究的结果反映了更广泛的护理提供问题。这项研究强调需要对家庭医生进行正规和有文件证明的培训，并分配管理和技术要求，以鼓励这些以及类似的医学和经济上合理的努力，这些努力似乎与医疗保健消费者的意愿完全吻合。

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