与家庭医生就生活、健康和幸福进行一次友好的交谈,曾是英国家庭医生服务的关键组成部分。
A friendly chat with your GP about your life, health and happiness was once a key part of the UK’s family doctor service.
但研究显示,大多数家庭医生不再有时间进行关怀式交谈,因为他们太忙于应对该国不断上升的疾病潮。
But most no longer have time to have pastoral conversations, because they are too busy dealing with the country’s rising tide of illness, research reveals.
英国皇家全科医师学会发现,四分之三的家庭医生现在时间太紧迫,无法深入与患者探讨如何戒烟、减重或获得更多睡眠。
Three out of four family doctors are now too time-pressed to talk to patients in depth about how they might stop smoking, lose weight or get more sleep, the Royal College of GPs has found.
强烈的需求和十分钟的预约时段意味着他们也错失了与患者讨论增加锻炼或复查药物以确认是否仍需服用的机会。
Intense demands and ten-minute appointment slots mean they also miss opportunities to discuss taking more exercise with patients or review their medications to see if they still need to be on them.
学会会长表示,深入了解患者情况并提供健康生活建议的时间已从家庭医生繁忙的日程中被挤占。
The time to explore patients’ circumstances more fully and offer healthy living advice has been squeezed out of family doctors’ busy schedules, the head of the college said.
英国皇家全科医师学会对全英2316名全科医生的调查发现,75%的医生时间太少,无法提供预防性医疗服务,如提供生活方式建议和接种疫苗。这些结果引发了人们对政府推动——尤其是全科医生——做更多工作以预防人们生病的担忧。一位健康专家称这些结果令人震惊。
The time to explore patients’ circumstances more fully and offer healthy living advice has been squeezed out of family doctors’ busy schedules, the head of the college said. An RCGP survey of 2,316 GPs across the UK found that 75% had too little time to offer preventative healthcare, such as offering lifestyle advice and administering vaccinations. The results have raised concern about the government’s drive for the– especially GPs – to do more to prevent people getting ill in the first place. One health expert called them alarming.
学会会长、在东伦敦行医的全科医生维多利亚·佐尔齐乌·布朗教授表示:“全科医疗面临巨大需求,因此在繁忙的诊疗中,我们不可避免地必须优先处理当天最需要我们关注的问题。
The college’s president, Prof Victoria Tzortziou Brown, who is a GP in east London, said: “General practice is dealing with enormous demand, so in a busy consultation we inevitably have to prioritise the problems that most need our attention that day.
“我们始终会针对需要检查或治疗的症状或发现采取行动。被挤占的,是退一步、从更整体的角度审视如何帮助患者长期保持健康的时间。”
“We will always act on symptoms or findings that need investigation or treatment. What can be squeezed out is the time to step back and look more holistically at how we can help that patient stay well in the long term.
“这可能意味着要与吸烟者进行一次深入的交谈。我们当然会建议患者戒烟。但在繁忙的诊疗中,可能没有足够的时间深入探讨他们是否想戒烟、过去戒烟困难的原因、他们的顾虑是什么,以及什么样的支持或治疗最适合他们。
“That might mean having a proper conversation with someone who smokes. We will of course advise patients about stopping smoking. But in a busy consultation there may not be enough time to explore in depth whether they want to stop, what has made it difficult in the past, what concerns they have and what support or treatment might work best for them.
‘往往是这些对话的深度,而不仅仅是识别风险并给予简短建议,才需要时间。’她表示,全科医生每天都在提供重要的预防性护理。但‘现实是,当你在繁忙的诊所工作,面对长长的待诊患者名单时,咨询时间往往不足以超越患者当天前来就诊的那个具体问题’。”
“It is often the depth of those conversations, rather than simply identifying a risk and giving brief advice, that requires time.” GPs already deliver important preventative care every day, she said. But “the reality is that when you’re working in a busy surgery, with a long list of patients to be seen, there isn’t always enough time in consultations to go beyond the issue a patient has come in for that day”.
国王基金会健康智库首席执行官莎拉·伍尔诺夫表示:“英国预期寿命在大多数可比国家中处于较低水平,这些发现令人担忧,因为许多全科医生表示他们工作负荷过重,无法实施这些重要的干预措施,可能会错过本可更早治疗的病情。
“It is often the depth of those conversations, rather than simply identifying a risk and giving brief advice, that requires time.” GPs already deliver important preventative care every day, she said. But “the reality is that when you’re working in a busy surgery, with a long list of patients to be seen, there isn’t always enough time in consultations to go beyond the issue a patient has come in for that day”.
‘全科医生常因预约需求不断增加而感到沮丧,因为他们没有时间提供受过训练的整体护理。’英国皇家全科医学学院在其报告中明确指出,英国国家医疗服务体系(NHS)需要雇佣更多全科医生,并确保他们有更多时间与患者相处,以实现预防雄心。”
The chief executive of the King’s Fund health thinktank, Sarah Woolnough, said: “With life expectancy in the UK among the lowest of most comparable countries, these findings are alarming as many GPs say they are too overwhelmed to carry out these important interventions, and may be missing conditions that could be treated earlier. “GPs are often frustrated that the increasing demands for appointments mean they don’t have time to provide the holistic care they were trained for.” The RCGP makes clear in its report that the NHS needs to employ more GPs and ensure they have more time with patients in order to fulfil the prevention ambition.
这些发现引发了对部长们计划的质疑,即让英格兰国家医疗服务体系在运作方式上“从治病转向预防”——这是政府去年十年健康计划中概述的三大“重大转变”之一。
“GPs are often frustrated that the increasing demands for appointments mean they don’t have time to provide the holistic care they were trained for.” The RCGP makes clear in its report that the NHS needs to employ more GPs and ensure they have more time with patients in order to fulfil the prevention ambition.
伍尔诺夫说:“如果我们连这些基本工作都做不好,谈论从治病转向预防就是毫无意义的。”
The findings raise questions about ministers’ plan to make the NHS in England move “from sickness to prevention” in how it operates – one of the three “big shifts” outlined in the government’s ten-year health plan last year.
“如果政府在预防方面是认真的,那么就需要采取更多行动来支持和赋能全科医生,使其能够持续早早发现疾病和健康问题,让人们更长久地保持健康,并减轻日后更广泛的NHS服务的压力。”
“Talk around shifting from sickness to prevention is meaningless if we cannot get these basics right first,” Woolnough said.
民调机构Censuswide为英国皇家全科医师学会(RCGP)对2000名英国选民进行的一项单独代表性调查显示,64%的公众信任家庭医生提供健康生活建议。
“If the government is serious on prevention, then more action is needed to support and enable GPs to consistently catch conditions and ill-health early, keeping people healthier for longer, and reducing pressures on wider NHS services down the line.” A separate representative survey of 2,000 UK voters which the pollsters Censuswide undertook for the RCGP showed that 64% of the public trust family doctors to offer advice on healthy living. That was more than trust the NHS website (51%), pharmacists (38%), family and friends (22%), AI chatbots (7%) and social media influencers (5%).
这一比例高于信任NHS网站(51%)、药剂师(38%)、家人和朋友(22%)、AI聊天机器人(7%)和社交媒体影响者(5%)的比例。卫生和社会保障部已被联系置评。
The Department for Health and Social Care was approached for comment.