第1讲 FM概论20150312.ppt

The Age of Specialization The first half of 20th century: the emergence of the major specialties of medicine with its defined training program and qualifying examination. Medical education emphasized laboratory science and technology Prestige of specialists and valuation of technical and research skill over personal care made general practice unpopular as a career. The Age of Specialization The Age of Specialization The fragmentation of the profession and the emphasis of technology leads to serious effect: deterioration of the doctor-patient relationship The neglect of the caring and personal aspects of medicine have negative consequences: increase in malpractice suits Return of General Practice The need for a new kind of generalists, who have a well-differentiated role and a defined set of skills-different from the old general practitioners The formation of colleges and academies of general practice in the 1950s and 1960s. And family medicine introduced into the undergraduate curriculum 1972 the World Organization of National College and Academies of General Practice /Family Medicine(WONCA) was formed General Practice or Family Practice Change of name from general practice to family practice or family medicine and from general practitioners to family physicians Academy of General Practice to Academy of Family Practice; the College of General Practitioners to the College of Family Physicians General Practice or Family Practice The reasons for the change-mixed General practice associated with an obsolete type of medicine Emphasis different concept of family practice from general practice To name a new body of knowledge on which the clinical discipline is based Training requirement The Changing Role of the Hospital Since 1960s, three levels of health care Primary level general practitioner provide continuing personal and comprehensive care Secondary level specialists provide service for special fields Tertiary level highly specialized services Rol