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重铸医师职业精神的话题正引发广泛的关注[1-6]。这种关注折射出一种情绪,就是对在影响美国当前医疗实践的各种力量中,经济因素似乎正占据着首位这一现实的深切忧虑。我们的普遍共识是,患者的利益必须优先于医师个人的经济利益,并且职业精神也要承诺服务于弱势群体和公民参与(civic engagement)。但是,由于评论家们把视线只集中在管理式医疗(managed care)和其他一些相关问题上,很多真知灼见被完全忽视,从而消解了许多推动当代医学职业精神的努力。
The topic of recasting physician professionalism is drawing widespread attention [1-6]. This concern reflects an emotion that is a deep concern for the reality that economic factors seem to occupy the first place in the various forces that affect the current state of medical practice in the United States. Our general consensus is that the interests of patients must take precedence over the individual physician’s financial interests and that professionalism also promises to serve the disadvantaged and civic engagement. However, since critics have focused their attention solely on managed care and other related issues, much of the insights have been completely ignored, thus dispelling many of the efforts to promote contemporary medical professionalism.