Is it time for a new definition of general practice?
BMJ 2000; 321 doi: https://doi.org/10.1136/bmj.321.7254.173 (Published 15 July 2000) Cite this as: BMJ 2000;321:173General practitioners' main interest is people
- Peter Davies, general practitioner (mail@alisonlea.co.uk)
- Alison Lea Medical Centre, East Kilbride G74 3BE
- University of Western Ontario, K101, London, Ontario N6A 5C1, Canada
- 16 Roskear, Camborne TR14 8DN
EDITOR—I have read the definitions of general practice in the editorial by Heath et al with interest but dissatisfaction.1 None of them is succinct, and they tend to stay closely allied to traditional biomedical viewpoints.
For me the key point about general practice is that it is the only medical specialty that is interested in people first and disease second. General practitioners are interested in personality, family patterns, and the effect of these on the presentation of symptoms as much as in diseases themselves. General practitioners (along with primary care researchers) are probably the only group currently trying to understand the relations between symptoms, health and illness, and specific diseases within communities. The focus is on the patient's response to the illness rather than on the illness itself.
General practitioners are interested in the ecology of health and illness within communities and in the cultural determinants of health beliefs.
General practitioners draw on a far wider range of resources than are taught in medical school, including their intuition, their knowledge of medicine, communication skills, business skills, and their own humanity. We are the only group of doctors who stay in attendance of chronically ill patients after the hospital clinics have lost interest.
In short, general practice is a specialty where doctors have their main interest in people and a secondary interest in disease.
The approach in general practice is broad and biocultural, in contrast to the older …
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