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【medical-news】初级医疗保健医生： 慢性疾病管理
Primary Care Doc: ‘The Chronic Disease Epidemic Is Upon Us’
Posted by Jacob Goldstein
obesityBen Brewer, a family doctor in rural Illinois, is one of a nation of primary docs trying to manage chronic disease in a system set up for handling acute problems. It’s an uphill battle.
His patients have grown more obese, and he’s seeing the complications of obesity — high blood pressure, diabetes — in ever younger patients. In his WSJ.com column this week, he writes:
We have drugs to treat the conditions. But we don’t have potent enough public health measures, patient education and follow-up monitoring to avoid the heart attacks, strokes and chronic kidney problems that come with the modern disease territory.
The way doctors get paid, it doesn’t make sense to spend an hour with a patient, talking about complex health problems. There’s more incentive to rush the patient through; the system pays when a poorly managed patient is hospitalized with serious (and often avoidable) complications.
Brewer’s trying a few new tactics to better manage chronic disease. His office uses a registry, that lets them alert patients who are overdue for routine tests or visits. In one case, a patient who had trouble controlling his blood sugar started emailing Brewer spreadsheets of his blood sugars every few days; Brewer emailed the patient back with advice about diet and insulin injections.
“His blood sugar came down to near normal within two weeks,” Brewer writes. 本人已认领该文编译，48小时后若未提交译文，请其他战友自由认领。 Primary Care Doc: ‘The Chronic Disease Epidemic Is Upon Us’
初级保健医生：慢性疾病管理是我们的责任
obesityBen Brewer, a family doctor in rural Illinois, is one of a nation of primary docs trying to manage chronic disease in a system set up for handling acute problems. It’s an uphill battle.
obesityBen Brewer，一个在Illinois农村工作的家庭医生，是我们这个为处理急性疾病而建立的医疗系统中尝试管理慢性疾病的一个初级医生。这种尝试是场艰难的斗争。
His patients have grown more obese, and he’s seeing the complications of obesity — high blood pressure, diabetes — in ever younger patients. In his WSJ.com column this week, he writes:
他的病人变得更加肥胖了，他在更年轻的病人中看到胃肥胖的并发症 高血压，糖尿病。在他的WSJ.COM专栏中，他写到。
We have drugs to treat the conditions. But we don’t have potent enough public health measures, patient education and follow-up monitoring to avoid the heart attacks, strokes and chronic kidney problems that come with the modern disease territory.
我们有治疗疾病的药物，但是我们没有足够强有力的公众健康管理措施，病人教育方案，和随访监督措施去避免属于心血管意外，中风，慢性肾脏疾病的发生。这些疾病都属于现代疾病领域。
The way doctors get paid, it doesn’t make sense to spend an hour with a patient, talking about complex health problems. There’s more incentive to rush the patient through; the system pays when a poorly managed patient is hospitalized with serious (and often avoidable) complications.
医生获得报酬的方式使得花上一小时和病人谈话，讨论复杂的健康问题变得没有意义。医生有更多冲动去应付一下病人，而当一个被控制得很差的病人因严重的并发症住院时，医疗系统才支付费用，而这些并发症通常都是能够避免的
Brewer’s trying a few new tactics to better manage chronic disease. His office uses a registry, that lets them alert patients who are overdue for routine tests or visits. In one case, a patient who had trouble controlling his blood sugar started emailing Brewer spreadsheets of his blood sugars every few days; Brewer emailed the patient back with advice about diet and insulin injections.
Brewer正尝试一些新的更好的管理慢性疾病的新策略，他的办公室使用一个新的登记处，这使得他的团队能警惕的发现一些需要规则检查和访视而延误的病人。在一个例子中，一个对控制他的血糖有困难的病人在开始每隔几天就电邮告知Brewer他的血糖。就电子邮件回复给出饮食，注射胰岛素的建议。
“His blood sugar came down to near normal within two weeks,” Brewer writes.
Brewer写到，"他的血糖在两个星期内就降到接近正常的水平。" 初级保健医生：慢性疾病管理是我们的责任
obesityBen Brewer，一个在Illinois农村工作的家庭医生，是我们这个为处理急性疾病而建立的医疗系统中尝试管理慢性疾病的一个初级医生。这种尝试是场艰难的斗争。
在他的WSJ.COM专栏中，他写到，他的病人变得更加肥胖了，他在更年轻的病人中看到肥胖的并发症 ——高血压，糖尿病。
我们有治疗疾病的药物，但是我们没有足够强有力的公众健康管理措施，病人教育方案，和随访监督措施去避免属于心血管意外，中风，慢性肾脏疾病的发生。这些疾病都属于现代疾病领域。
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作者:admin@医学,生命科学 2011-07-31 17:11
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