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Introduction

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Medical practice is not knitting and weaving and the labour of the hands, but it must be inspired with soul and be filled with understanding and equipped with the gift of keen observation; these together with accurate scientific knowledge are the indispensable requisites for proficient medical practice.

Moses Ben Maimon (1135–1204)

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General practice is a traditional method of bringing primary health care to the community. It is a medical discipline in its own right, linking the vast amount of accumulated medical knowledge with the art of communication.

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Definitions

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General practice can be defined as that medical discipline which provides ‘community-based, continuing, comprehensive, preventive primary care’, sometimes referred to as the CCCP model. It is regarded as synonymous with primary care and family practice.

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The Royal Australian College of General Practitioners (RACGP) uses the following definitions of general practice and primary care:

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General practice is that component of the health care system which provides initial, continuing, comprehensive and coordinated medical care for all individuals, families and communities and which integrates current biomedical, psychological and social understandings of health.

A general practitioner is a medical practitioner with recognised generalist training, experience and skills, who provides and co-ordinates comprehensive medical care for individuals, families and communities.

General/family practice is the point of first contact for the majority of people seeking health care. In the provision of primary care, much ill-defined illness is seen; the general/family practitioner often deals with problem complexes rather than with established diseases.

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The RACGP has defined five domains of general practice:

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  • communication skills and the doctor–patient relationship

  • applied professional knowledge and skills

  • population health and the context of general practice

  • professional and ethical role

  • organisational and legal dimensions

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Furthermore the RACGP has identified seven core characteristics of general practice:

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  1. whole person care

  2. person centredness

  3. continuity of care

  4. comprehensiveness

  5. diagnostic and therapeutic skills

  6. a command of complexity and uncertainty

  7. coordinated clinical teamwork

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The American Academy of Family Physicians (AAFP) has expanded on the function of delivery of primary health care.1,2

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Primary care is a form of delivery of medical care that encompasses the following functions:

  1. It is ‘first-contact’ care, serving as a point-of-entry for patients into the health care system.

  2. It includes continuity by virtue of caring for patients over a period of time, both in sickness and in health.

  3. It is comprehensive care, drawing from all the traditional major disciplines for its functional content.

  4. It serves a coordinative function for all the health care needs of the patient.

  5. It assumes continuing responsibility for individual patient follow-up and community health problems.

  6. It is a highly personalised type of care.

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Pereira Gray3 identifies six principles—primary care, family care, domiciliary care and continuing care, all designed to achieve preventive and ...

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