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不仅是职业倦怠——重新设计医疗体系,帮助医师恢复价值和心理健康
Beyond Burnout — Redesigning Care to Restore Meaning and Sanity for Physicians


Alexi A. Wright ... 其他 • 2018.01.25

2016年后期,一名事业蒸蒸日上的初级诊疗医师决定关门歇业。在新的电子病历(EHR)系统中挣扎一年后,她终于觉得不得不退休了。这已是她过去行医生涯中的第四个电子病历系统,但这次的转变有所不同。新系统并未改善效率,反而占用更多留给患者的时间,增加每日文书工作量,并且在“有意义地应用”医疗系统信息技术方面,以政府的衡量指标替代了她个人的临床判断。

“我们在花费时间做错误的事,”执业内科医师、美国医学会(American Medical Association)职业满意度部门副主管Christine Sinksky说,其已开展数项研究追踪医师的时间分配情况,“在最高层面上,我们已与目标偏离,已与工作中能带来快乐和工作意义的事情失去联系。”





作者信息

Alexi A. Wright, M.D., M.P.H., and Ingrid T. Katz, M.D., M.H.S.
Drs. Wright and Katz are national correspondents for the Journal.

 

参考文献

1. Sinsky C, Colligan L, Li L, et al. Allocation of physician time in ambulatory practice: a time and motion study in 4 specialties. Ann Intern Med 2016;165:753-760.

2. Shanafelt TD, Hasan O, Dyrbye LN, et al. Changes in burnout and satisfaction with work-life balance in physicians and the general US working population between 2011 and 2014. Mayo Clin Proc 2015;90:1600-1613.

3. Panagioti M, Panagopoulou E, Bower P, et al. Controlled interventions to reduce burnout in physicians: a systematic review and meta-analysis. JAMA Intern Med 2017;177:195-205.

4. Physician burnout is a public health crisis: a message to our fellow health care CEOs. Health Affairs Blog. March 28, 2017 (https://www.healthaffairs.org/action/showDoPubSecure?doi=10.1377%2Fhblog20170328.059397&format=full).

5. Shanafelt TD, Gorringe G, Menaker R, et al. Impact of organizational leadership on physician burnout and satisfaction. Mayo Clin Proc 2015;90:432-440.

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