What is general clinical competence? Facing the theoretical challenge to general practice

Area of Science:

• General Practice and Primary Care Medicine
• Clinical Competence Research
• Medical Sociology

Background:

• General practice faces challenges with a pragmatic approach, potentially leading to an undefined scope and perceived replaceability.
• Despite this, most practitioners believe their role is specific, highlighting a theoretical gap in defining general clinical competence.
• Clarifying this competence is crucial for understanding the core of general practice and its position within the broader medical field.

Purpose of the Study:

• To identify and define the core components of general clinical competence.
• To explore how general practice mediates between patients and biomedicine.
• To establish a theoretical foundation for the unique contribution of general practice.

Main Methods:

• Analysis of the relevance of clinical epidemiology, patient-centered clinical methods, problem-solving strategies, and communication to general clinical competence.
• Focus on the understanding of symptom presentation as a crucial area.
• Conceptualization of "bodily empathy" as a key element.

Main Results:

• General clinical competence is significantly linked to the understanding of symptom presentation, which often reflects the patient's experience of their "lived-body".
• Bodily empathy, the understanding of the patient's "lived-body", is identified as a crucial constituent of general clinical competence.
• This competence is distinct from specialized medical knowledge and is central to the practice of general practitioners.

Conclusions:

• Bodily empathy is proposed as a major component and the foundational element of general practice as a discipline.
• Refining bodily empathy can clarify the specific contribution of general practice and strengthen its professional identity.
• Addressing this theoretical challenge can help prevent an overly broad and undefined agenda in general practice.