[Significance of diagnostic aspects in general practice]

The role of the 'diagnosis' in general practice is different from that in teaching hospitals, but a broader definition is needed. In general practice the spectrum of diagnoses appears to be almost unlimited ('for every patient his own diagnosis'). Therefore, the author calls in question any classification system. In a personal study of 300 consultations in the offices of six Swiss general practitioners, no main diagnosis was reported in 16%, and in one third the main diagnosis was uncertain. The impact of the diagnosis on the therapeutic consequences or on prognosis seems to be overestimated. Of the stated diagnoses most were somatic, but not in the sense of 'clinical' entities. Only few patients are interested in our diagnostic terms. Significant inter-practitioner variations in the diagnostic approach are discussed.