社區為導向的家庭醫業

隨台灣歷經1999年921大地震及2003年SARS之考驗後，確認重建社區醫療體系為今後醫療與保建之重心工作。完整的社區醫療體系自然是以家庭醫學專科醫師為核心，結合社區中之基層醫療團隊、社區醫院和社區資源，進行以社區為導向的家庭（基層）醫業，從事社區健康營造，或與施行以醫院與基礎之社區醫療的社區醫院結合成為完整的社區醫療照顧體系共創家庭醫師制度之來臨。

關鍵字

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並列摘要

Family practice is the medical practice where the family is always the central focus of the practice. A community is composed of all families residing in a defined geographic area and the family physicians too redundant so omit are intended to provide care for all families in the community. This is called community-oriented family practice. In 2002 there are 68 Family Practice Residency Training Programs in Taiwan, and all of them are sponsored by hospitals. Consequently all Family Practice Residency Training Programs offer a relatively hospital-based curriculum for training the future family physicians. However, due to a long tradition of community activities of the hospitals, increased competition among hospitals, continuous changes in the health care delivery systems, and the implementation of the “Community Health Construction Project” by the National Department of Health in 1999, many hospitals began to experiment in “hospital-based community medicine”, which include 3 models: (a) engagement in “community health construction” activities, (b) linkage with primary care settings in the community, or (c) implementation of the community-oriented family practice through the Department of Family and Community Medicine of the hospital. The Taiwan Association of Family Medicine (TAFM) which was established in 1986, has made the community medicine rotation a required curriculum of the family practice residency training program. Moreover, beginning in 2003, all PGY1 (Postgraduate Year 1) residents are required to receive a one-month community medicine rotation to fulfill the prerequisite for medical licensure. Thus many hospitals are requesting the Department of Family and Community Medicine to offer community medicine rotations for the PGY1 resident in other specialties. It is expected that community medicine, both its training and services, has become more and more important to almost all hospitals. In addition, training of the community-oriented family practice for future family physicians is a top priority in the curriculum of all family practice residency training programs.