Abstract: Background　Consultation competence is one of the essential abilities that a general practitioner（GP）must have.However，at present consultation competence of community GPs in China still needs to be improved.Objective　To explore the current situation of the consultation ability of community GPs and find the existing problems in Guiyang in order to provide a scientific reference for further improving the consultation competence of GPs.Methods　A total of 112 GPs in 36 community health service centers selected by the stratified random sampling from 64 community health service centers in six urban districts of Guiyang were investigated from April to July in 2018.Observation method with a self-designed scoring table was employed to evaluate the performance of the GPs when diagnosing patients.The scoring table with a total score of 0-127 points explored and evaluated the consultation competence of GPs from four aspects，including identifying and addressing current problems（0-67），managing continuous problems（0-23），preventive care（0-28）and improving medical compliance behavior（0-9）.Results　The average scores for these 112 GPs in identifying and addressing current problems，managing continuous problems，preventive care，improving medical compliance behavior and total score were（23.69±3.22），（7.64±2.39），（3.49±3.21），（1.86±1.41），（35.65±7.29），and the proportions of good level of abilities in four aspects and overall were 15.2%（17/112），16.1%（18/112），18.8%（21/112），11.6%（13/112） and 19.6%（22/112） respectively.Conclusion　At present，all the four major consultation competence of the community GPs in Guiyang need to be improved.It is necessary to strengthen the training of thinking in general practice and make full use of health records，consultation records and various life stress scales in the actual practice.Besides，the organic integration of outpatient medical care and public health services should be adopted to further improve the consultation competence of the community GPs.

Key words: General practitioners, Consultation competence, Observational method, Guizhou

摘要： 背景　应诊能力是全科医生必备的基本能力之一，现阶段我国社区全科医生的应诊能力不容乐观。目的　了解贵阳市社区全科医生应诊能力现状，发现存在的问题，为进一步提高全科医生的应诊能力提供科学的参考依据。方法　于2018年4—7月，采用分层随机抽样的方法从贵阳市六城区64家社区卫生服务中心中抽取36家，将36家社区卫生服务中心的所有从事全科门诊的医生112名作为调查对象。运用观察法，依据自制评分表对全科医生接诊患者时的行为表现进行评分，评分表从确认和处理现患问题、连续性问题的管理、预防性照顾、改善就医遵医行为4个方面对全科医生的应诊能力进行评价，4个方面得分范围分别为0~67、0~23、0~28、0~9分，总分0~127分。结果　112名全科医生确认和处理现患问题、连续性问题的管理、预防性照顾、改善就医遵医行为平均得分分别为（23.69±3.22）、（7.64±2.39）、（3.49±3.21）、（1.86±1.41）分，平均总得分为（35.65±7.29）分；4个方面能力水平处于好的人数占比分别为15.2%（17/112）、16.1%（18/112）、18.8%（21/112）、11.6%（13/112），总体评价为好的人数占比为19.6%（22/112）。结论　当前贵阳市社区全科医生的应诊能力需要提升。应加强全科医生全科思维的培养，在实际工作中充分应用健康档案、《接诊记录表》及各种生活压力量表，将门诊医疗与公共卫生服务进行有机整合，以提高全科医生的应诊能力。

关键词: 全科医生, 应诊能力, 观察法, 贵州