General Practice & Family Medicine

High quality primary health care depends on the availability of well trained general practitioners or family physicians as members of health care teams in the community. The general practitioner or family physician is the physician who is primarily responsible for providing comprehensive health care to every individual seeking medical care, and arranging for other health personnel to provide services when necessary.

The general practitioner/family physician cares for the individual in the context of the family, and the family in the context of the community, irrespective of race, culture or social class he/she is clinically competent to provide the greater part of their care, taking into account the cultural, socioeconomic and psychological background.

Commitments Made By The General Practitioner / Family Physician

1) TO THE COMMUNITY

Overall objectives

• To have knowledge of the epidemiology of the community being served.
• To have maximum influence on any health problem in the community

Support in the community

• To understand health-related behaviours in the community and to support the community’s own
  efforts to safeguard the health of the population.
• To look upon the services provided by the practitioners of alternative systems of medicine that are
  scientifically acceptable as an essential resource, and to make the fullest possible use of these.
• To include in the care provided: prevention of illness, promotion of health, management of illness,
  and rehabilitation

2) TO THE INDIVIDUAL

Comprehensive care

• To identify all the problems presented by the patient, including undifferentiated problems, early
  states of illness, acute problems, chronic diseases, psychological problems, and rehabilitation
  needs.
• To define what is needed to heal the patient in both biomedical and humanistic terms; that is,
  physically, mentally and socially.
• To diagnose prevalent disease, to eliminate possible serious disease, and to coordinate other health services when needed.
  

3) Family Focus

To consider the relationships between the physician and the patient, and the physician and patient’s family, as important aspects of health care.

The general practitioner/family physician continues to serve as the advocate for the patient regardless of the level of care within the system which the patient requires. Such advocacy includes helping the patient and/or family to take an active part in the clinical decision-making process. The plan for management is negotiated with the patient with due regard to cost effectiveness.

4) Coordination with other services

General/family practice differs from other specialties in the following respects:

• The general practitioner/family physician often deals with undifferentiated clinical problems, ie. problems that have not previously been assessed by a physician.
  
  
• Even after full assessment, a significant proportion of problems cannot and do not need to be diagnosed in the usual sense of the term. Many clinical decisions have therefore to be made without a precise clinical diagnosis. Knowledge of the patient often plays a big part in these decisions. Often the most important task is to eliminate the possibility of serious disease.
  
  
• The prevalence of disease in general practice is very different from its prevalence in the selected population of a hospital clinic or ward. Since the predictive value of clinical data varies with the prevalence of a disease in a given population, the same symptom, sign or test may have a different predictive value in general/family practice from that in hospital practice.