در این بخش مبحث نیروی کار و آموزش در پزشکی جامع بررسی می شود. شما برای دریافت کامل این کتاب یا ترجمه آن می توانید از بخش نظرات وبلاگ استفاده کنید و با ما تماس بگیرید. در اینجا فقط ابتدای این بخش از کتاب که به اجلاس سال 2009 مربوط می شود برای شما عزیزان درج شده است.
Regulation has been viewed as necessary ever since Adam Smith
famously observed, in The Wealth of Nations, that “[p]eople of the same
trade seldom meet together, even for merriment and diversion, but the
conversation ends in a conspiracy against the public.” But, in The Theory
of Moral Sentiments, Smith suggested that it is the conscience of the pro-
fessional, not regulation, that provides the greatest protection to the pub-
lic.
To do some good, Chantler said, the evidence base for complemen-
tary medicine should be built on effectiveness. While it is always desir-
able to understand the efficacy of an intervention—that is, whether an
intervention works under ideal conditions, such as those of a clinical
trial—it is possible to study the effectiveness of a treatment for patients in
routine clinical care without having a full understanding of its efficacy.
This may be particularly important with complex interventions that have
psychological as well as pharmaceutical or physical components. Evalua-
tion should ensure that a treatment is safe, beneficial, and cost-effective.
The latter is especially important in establishing the value for public in-
vestment.
The evidence base, in Chantler’s opinion, should include a combina-
tion of clinical outcomes, measures of patient satisfaction, and patient
outcome measures, such as normal activities of daily living. It is impera-
tive to know how well patients with chronic diseases are functioning
over the course of time.
Most interventions, Chantler pointed out, now require integration—
within and among different professions, different care modalities, and
different locations, because much of the care provided takes place out-
side the hospital. This gives fundamental importance to maintaining an
up-to-date and thorough medication record, including treatments pro-
vided through complementary modalities. Even if a single electronic
health record for patients in all circumstances is not yet feasible, Web-
based systems are being developed so that a contemporary summary can
be made available to all practitioners involved in the patient’s care.
Chantler emphasized that integrative care requires such thorough com-
munication.