Intended for healthcare professionals


Should general practice be a specialty in its own right?

BMJ 2016; 354 doi: (Published 27 September 2016) Cite this as: BMJ 2016;354:i5097
  1. Richard J McManus, professor,
  2. F D Richard Hobbs, professor
  1. Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford OX2 6GG, UK
  1. Correspondence to: R J McManus richard.mcmanus{at}

GPs in the UK are already specialists in all but name

General practice as known today in the UK developed in the 19th and early 20th centuries.1 General practitioners (GPs) became gradually separated from physicians and surgeons centred in hospitals and took on the role of a personal doctor working in the community. This generalist role was differentiated from “specialists,” who consulted patients referred to them by GPs.

However, the respective roles of GPs and hospital specialists have become blurred, especially since the 1990s, with GPs taking on much of the traditional hospital care in the diagnosis and management of major diseases (diabetes, hypertension, thyroid disease, mental health); most preventive medicine (cancer screening, immunisation, maternity); and even minor procedures (insertion of intrauterine devices, joint injections, and lesion removal). This has resulted in the disappearance of the general physician role within hospitals and greater specialisation of consultants. What has not transferred has been the specialist label for the doctors now delivering …

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