미래의 글로벌 의료를 위해 우리가 교육하고 있는 의사

미래의 글로벌 의료를 위해 우리가 교육하고 있는 의사

The doctor we are educating for a future global role in health care

STEFAN LINDGREN1 & DAVID GORDON2

세계의 많은 지역에서 금전, 시설, 인력 측면에서 의료는 많이 부족하다. 부유한 국가에서는 의료의 비용과 복잡성의 상승이 끊일 줄을 모른다. 그럼에도 불구하고 부유한 국가는 더 많은 의사가 필요하다고 외치고 있으며, 가난한 나라에서 의사가 이민올수록 전세계적인 보건의료인력의 위기(global health workforce crisis)는 더 심해진다.

이러한 정치적, 사회적, 국제적 사건을 볼 때, 오늘날 전세계적인 관점에서 의사의 역할과 가치에 대한 토론이 필요하다. 이제 의사와 환자가 모두 세계 어디로든 이동할 수 있게 되었다. 따라서 의사의 역할과 가치가 전세계적 관점에서 합의가 이루어져야만 그 역할을 할 수 있는 의사를 키워내는 교육도 가능할 것이다. 

의사는 특정 지역의 자원과 필요에 따라 유동적으로 구성될 수 있는 보건의료팀의 구성원이자 지도자로서 필요하며, 동시에 어떤 보건의료 시스템 하에서도 의사로서의 역할을 할 수 있어야 한다. WFME의 국제 task-force는 이러한 국제적 의사의 역할이라는 주제로 전세계적으로, 의학교육 정책 개발에 활용될 수 있는 성명서(statement)를 작업중에 있다.

• Professionalism; its meaning and significance today, and its relevance for personal development

• The doctor as communicator, educator and researcher

• Demographic changes, migration and the future of medicine

• The doctor as a manager of health care within society, and as a community health leader

• The social accountability of medicine and the doctor

• Leadership and membership within the health care team

  
  

  
  

• Mismatch of competencies with patient and population needs

• Teamwork

• Hospital specialist orientation at the expense of primary care

• Leadership

• Leadership to improve health-system performance

• Partnership approach with patients, for long-term health gain

• Social accountability

• Difficult decisions in situations of complexity and uncertainty

• Communication

• Professionalism

• Physician–scientist

• Generalist

• Capacity to change

• Profound ethical understanding

• Life-long learner

• Habits of inquiry and improvement

• Striving for excellence

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Conclusions

Preliminary conclusions on the future roles of the doctor stress the importance of professionalism, combined leadership and membership of health care teams of varying composition, a scientific perspective on continuous improvement of medical practice and its management and the social accountability to society and the needs of the patients. 

At the same time, the doctor should be a highly educated professional with responsibility for ultimate decisions in uncertain and complex situations. The solution to the global health workforce crisis is not only to produce more doctors. Instead, we must consider the needs of the population, society and the individual doctor as a professional in a flexible approach, within the economic and social circumstances of the country or region, to the composition of health care teams and systems. Clear definitions of the global roles and values of doctor is an important step in that direction.

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Med Teach. 2011;33(7):551-4. doi: 10.3109/0142159X.2011.578174.

The doctor we are educating for a future global role in health care.

Lindgren S, Gordon D.

Source

Department of Clinical Sciences, University of Lund, Sweden. Stefan.Lindgren@med.lu.se

Abstract

Health care is deficient in many parts of the world, in money, facilities and manpower. In wealthy countries, the costs and complexity of health careare increasing unsustainably. Nevertheless, richer countries claim an ever escalating need for doctors, who migrate from poorer countries, with an ensuing global health workforce crisis. These political, social, demographic and international events necessitate a discussion on the roles and values of the doctor in the world today. The international mobility of both doctors and patients underlines the need for a global definition. Only when these roles and values are agreed in a global perspective, will medical education be capable of producing a professional equipped to fulfil that role. Thisdoctor will then be useful both as a leader and as a member of health care teams with a flexible composition, related to resources and needs of particular regions, and at the same time be able to practise within any given health care system. An international task-force of the World Federation for Medical Education (WFME) is working to agree themes relevant to the role of the doctor globally, and developing a statement that can be used world-wide, and used to develop medical education policy.

PMID:

 

21696281

 

[PubMed - indexed for MEDLINE]