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Exploring the GP-patient relationship: a historical narration.

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Area of Science:

  • Medical Sociology
  • History of Medicine
  • General Practice

Background:

  • The patient-doctor relationship is central to general practice, yet historical, professional, and sociopolitical contexts influencing it are under-researched.
  • Recent concerns about a crisis in UK general practice highlight declining relational encounters and the need to examine contextual factors.

Purpose of the Study:

  • To explore the historical evolution of general practitioner (GP)-patient relationships in the UK.
  • To analyze how professional, sociopolitical, and philosophical contexts have shaped the experience and portrayal of these relationships over time.

Main Methods:

  • Episodic narration (chronicling) to examine five distinct periods of UK general practice (1815-present).
  • Analysis of diverse sources including personal reflections, professional publications, political policies, art, and literature for micro and macro viewpoints.

Main Results:

  • Identified significant influences of epidemiological realities, the socioprofessional role of GPs, and broader sociopolitical/philosophical frameworks.
  • Highlighted the critical impact of ideological frameworks (socialism, free market, neoliberalism) on funding, service structures, and regulation.
  • Demonstrated how these contextual factors incentivize or inhibit GP-patient relationship enactment.

Conclusions:

  • Meaningful GP-patient connections are valuable and consistently emphasized by GPs.
  • An honest discussion about the necessary contexts to enable and retain these relationships is crucial for the future of general practice.