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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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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 coordinates 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 eight core characteristics of general practice:
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whole person care
person centredness
continuity of care
comprehensiveness
diagnostic and therapeutic skills
a command of complexity and uncertainty
coordinated clinical teamwork
leadership, advocacy and equity
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Additional functions of primary health care promoted by the American College of Family Physicians (AAFP).1,2
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First contact care including the early diagnosis of acute disease
Continuity of care for the individual patient, their family and his/her environment
Highly personalised care
Care of chronic disease
Gatekeeper care or co-ordinating role drawing on traditional major disciplines
Community health awareness
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General practice is fundamentally relational, based on the doctor having a deep understanding of the whole person and the ability to manage complex conditions and circumstances. The general practitioner functions as a physician, counsellor, advocate and agent of change for individuals, families and their communities.3
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General practice is not the summation of specialties practised at a superficial level and we must avoid the temptation to become ‘specialoids’. In the current climate, where ...