Læknablaðið - 01.06.1977, Page 75

LÆKNABLAÐIÐ
123
THE GENERAL PRACTITIONER IN EUROPE
A STATEMENT BY THE WORKING PARTY APPOINTED
BY THE SECOND EUROPEAN CONFERENCE ON THE
TEACHING OF GENERAL PRACTICE
(Leeuwenhorst Netherlands 1974)
INTRODUCTION
Dramatic changes have taken place in
medical diagnosis and treatment in recent
years; the growth of medical knowledge,
and of knowledge in other fields relevant
to medicine 'has contributed to increasing
specilisation. The point has long been
passed at which one person could
have more than a general knowledge
of all areas of medicine. Any doctor's
approach to the individual‘s problem
has to be highly organised and syste-
matic if he is to make effective and eco-
nomical use of elaborate diagnostic and
therapeutic services; at the same time he
will have to continue to make a distinctive
human contribution to the process by
approaching the problem with imagination
as well as by achieving a close personal
relationship with the patient and eliciting
information that no mechanical or organi-
sational aid can provide.
As progress in science and teohnology
continues, attitudes towards doctors, as
towards members of other professions,
are likely to move still further in the
direction of regarding them as experts
to be called in to prevent, investigate
and remedy specific functional defects
rather than as members of an elite who
are accorded a special status my virtue
of their general background and qualifica-
tions. The very fact that the doctor is con-
cerned with the most personal aspects of
human health, and indeed with the funda-
mental matters of life and death, will
ensure that his profession will continue to
be held in high regard; but the esteem in
which the doctor is held by the community
in general will be determined much more
by his demonstrated competence and atti-
tude than by the mystique of his calling.
A separate but related development is
the increasing need for the doctor to work
in close cooperation, in prevention, dia-
gnosis and therapy, with people who are
not medically qualified. These include not
only the scientists whose contribution to
clinical assessment is becoming increasing-
ly important, but also the many other pro-
fessional people who have skills and ser-
vices to offer the patient, and above all
the patient himself — a patient better in-
formed and more interested in science and
medicine that doctors have often en-
countered hitherto. The doctor‘s chief con-
tribution will be his knowledge of the clini-
cal situation, his ability to exercise a deci-
sive influence on the patient's illness, and
his capacity to guide and co-ordinate the
work of others whose cooperation is essen-
tial. This applies to general practitioners
as to ot'her doctors in narrower fields of
practice.
The general practitioner‘s specific role
is to care for any human being as a whole
person in his own environment; his con-
cern goes beyond the requirements of
a particular „incident“ of illness. He inter-
prets the patient‘s needs and demands in
biological and pathological as well as in
social and psyöhological terms. He provides
continuity of care, irrespective of the
numbers of incidents or types of illness
that the patient may encounter.
He differs from those in other fields of
practice in that he does not restrict his
work to any particular part or system of
the human body, or to any particular form
of prevention, diagnosis or treatment, or
to a group of patients specified by age, sex
or disease.
The description of the work of a general
practitioner whioh follows is intended as
a basis for the establishment of education
and training for new entrants to the spe-
cialty.