Abstract：
This study examined variation in medical practitioners\' practice-based conceptions of what it means to be a doctor, based on interviews with 30 clinicians who were also medical educators. Participants included general practitioners, surgeons and physicians (non-surgical specialists). Participants were asked to draw a concept map of \'being a doctor\', followed by semi-structured interviews using a phenomenographic research design. Three conceptions were identified, varyingly focused on (1) treating patients\' medical problems; (2) maximising patients\' well-being; and (3) maximising community health. Each conception was distinguished by variation in awareness of six underlying dimensions of being a doctor: (1) doctors\' actions; (2) treatment success; (3) patients\' actions; (4) patients\' well-being; (5) community needs; and (6) social justice. Whilst all participants included dimensions 1 and 2 in their described practice, numerous participants did not include dimensions 3 and 4, i.e. did not take the patients\' role and the impact of patients\' psychosocial context into account in their practice. This is concerning, especially amongst medical educators, given the widely acknowledged importance of patient-centred care in medical practice. Similarly, only some of the participants considered community health needs and felt a broader social responsibility beyond their responsibility to individual patients. These findings highlight aspects of the medical profession that need to be further emphasised in medical training and continuing professional development.
摘要：
这项研究调查了医生的“基于实践的概念对医生意味着什么的变化，基于对30名同时也是医学教育者的临床医生的访谈。参与者包括全科医生，外科医生和内科医生（非手术专家）。要求参与者绘制“成为医生”的概念图，其次是半结构化访谈，使用现象研究设计。确定了三个概念，不同地关注（1）治疗患者的医疗问题；（2）最大化患者的福祉；（3）最大化社区健康。每个概念都通过对成为医生的六个基本维度的认识变化来区分：（1）医生的行动；（2）治疗成功；（3）患者的行动；（4）患者的福祉；（5）社区需求；（6）社会正义。虽然所有参与者在他们描述的练习中都包括维度1和维度2，许多参与者没有包括维度3和维度4,即在他们的实践中没有考虑患者的角色和患者的社会心理背景的影响.这是关于,尤其是在医学教育工作者中，鉴于以患者为中心的护理在医疗实践中的重要性得到了广泛认可。同样，只有部分参与者考虑到了社区健康需求,并感受到了更广泛的社会责任,而不仅仅是他们对个体患者的责任.这些发现突出了医学专业的各个方面，需要在医学培训和持续的专业发展中进一步强调。
