Primary Care: Proposed Solutions To The Physician Shortage Without Training More Physicians

被引:213
|
作者
Bodenheimer, Thomas S. [1 ]
Smith, Mark D. [2 ]
机构
[1] Univ Calif San Francisco, Dept Family & Community Med, San Francisco, CA 94143 USA
[2] Calif HealthCare Fdn, Oakland, CA USA
关键词
RANDOMIZED CONTROLLED-TRIAL; US HEALTH-CARE; LOW-BACK PAIN; CASE-MANAGEMENT; SURVEY SHOWS; POPULATION; WORKFORCE; IMPROVE; ADULTS; COMMUNICATION;
D O I
10.1377/hlthaff.2013.0234
中图分类号
R19 [保健组织与事业(卫生事业管理)];
学科分类号
摘要
The adult primary care "physician shortage" is more accurately portrayed as a gap between the adult population's demand for primary care services and the capacity of primary care, as currently delivered, to meet that demand. Given current trends, producing more adult primary care clinicians will not close the demand-capacity gap. However, primary care capacity can be greatly increased without many more clinicians: by empowering licensed personnel, including registered nurses and pharmacists, to provide more care; by creating standing orders for nonlicensed health personnel, such as medical assistants, to function as panel managers and health coaches to address many preventive and chronic care needs; by increasing the potential for more patient self-care; and by harnessing technology to add capacity.
引用
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页码:1881 / 1886
页数:6
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