Medical Professionalism Maintenance and Its Obstacles in Contemporarv U. S.

近年来随着医学知识爆炸、临床工作团队化、医师利益冲突、卫生资源分配不均衡等新老问题的出现,美国医疗行业对医师职业精神的维护做出了不懈的努力.通过介绍教育和行业组织结构,行业管理机制,以及医师职业精神的维护在历史中的演变,从美国医疗行业自治、医学教育和业内资质认证三方面,综述美国医疗行业如何持续维护医师职业精神,以及在当前环境下美国维护医师职业精神面临的问题.其中主要问题有:自治组织的管理模式改进问题,医学继续教育的设计及利益冲突问题,医师资质认证的频率及考试内容设计问题等.In recent years, medical profession in the U.S.has been making continuous great efforts to maintain medical professionalism while facing old and new problems and challenges, such as explosion of medical knowledge, team-work based clinical practice, conflicts of interests in clinical practice, and imbalance allocation of health resources.By introducing educational and professional organization structures, profession management mechanism, and the change of medical professionalism maintenance in history, this article summarizes the maintenance of medical professionalism and its obstacles in self-governance of medical profession, medical education and qualification accreditation of medical profession.The main problems are changes of management model in self-governance organization, design of continued medical education, conflicts of interests in continued medical education, frequency of physician qualification accreditation, and design of qualification test content.1532-353