优质家庭医学服务需求TheNeedsofGoodFamily.ppt

8th Beijing Hong Kong Medical Exchange第八屆京港醫學交流會議 2006 The Needs of good Family Medicine Practice 優質家庭醫學服務的需求 By 講者 Yuen Chung Lau, Nat 阮中鎏醫生 Why do we need good family practice? 我們為什麼需要優質家庭醫學服務？ How do we achieve those needs? 我們怎樣實踐那些需要? Why do we need good family practice? 我們為什麼需要優質家庭醫學服務？ (1) The modern trend of specialization is changing. Holistic medical care is now in vogue. 醫學的迅速發展和專業化的趨勢改變了大部分醫學景象。 (2) Different diseases are treated by different specialists. Therefore many medicines could be prescribed for one person with many conditions. Thus we need a good family doctor to co-ordinate better use of all these medicines. 多方面的專家治療不同的疾病。一個患有多種疾病的人將被處方很多藥物。 因此，我們需要一位良好家庭醫生，有效地協調使用所有藥物。 (3) Let me use a case to illustrate my points. Mrs Chan, a 76 year old widow, living alone with a domestic helper, had just been discharged from hospital one week ago. This was her second admission in 5 weeks. She had been feeling dizzy, no appetite, chest discomfort, weakness in the limbs and could not sleep for the last 3-4 days. Her husband died 9 months ago of a cardiovascular accident. She has 3 sons and one daughter, all married and live away from her. 用以下一種情況來說明我的觀點。 陳太太，一位76歲寡婦，獨居，有一家務助。一個月前出院，這次是她在五週內第二次入院了。最近3至4天，她感到眩暈、沒胃口、胸口不安、四肢乏力及不能入睡。 九個月前，她的丈夫死於心血管意外。 她有3個兒子和一個女兒。 他們全部已婚且不跟她同住。 She showed me she had been taking 2 medicines for diabetes, 2 medicines for blood pressure, one medicine for chest discomfort, one for lowering her cholesterol, one for her uric acid, and one for arthritis of her knees. She had been taking a total of 8 different types of medicine. After a careful history and examination, Mrs Chans conditions appeared under control. 她讓我看她正服用的藥物，包括2種糖尿病藥， 2種血壓藥， 1種胸口不安藥， 1種降膽固醇藥， 1種尿酸藥和1種膝關節炎藥。 可見她總共服用8 類不同藥物。 在小心記錄病歷和檢查之後，陳太太的情況開始受到控制。 . However, Mrs. Chan appeared unhappy, living alone, crying easily, not sleeping well and not wanting to live any more. It is obvious that Mrs. Chan, in addition to her mult