[Do we use the potential of the general medicine consultation?]

Is there any congruence between vocational training as general practitioner and the needs of patients in primary care in Switzerland? What are the respective needs in the next century? These questions are discussed, based on the personal experience of the author after having completed his vocational training as general practitioner, on three years of experience as research fellow in a descriptive, cross-sectional and observational study of 300 consultations on the premises of six general practitioner-investigators and on a review of key research literature. Controversial views on the potential and the gaps in today's primary care are shown, focused on definition, training and research in the field of general or family practice. Of a broad range of experiences, two are pointed out: significant interindividual differences in practice patterns in primary care and emerging differences between primary care and teaching hospital medicine. The exceptional potential of primary care consultations has much to contribute to needed reforms in medical education and the health care system for the 21st century. Primary-care-based research and training will develop improved skills e.g. in communication, medical decision-making and patient management. Primary care is a discipline which includes insecurity and individuality; therefore, open questions and constant changes will be part of present and future for us and our patients.