Roles of the general practitioner in different contexts

Area of Science:

• Healthcare Management
• Public Health Policy
• Medical Practice Evolution

Background:

• General practice roles vary significantly across different healthcare contexts and historical developments.
• Western general practitioners were historically excluded from hospitals and public health, leading to a focus on first-line curative care.
• In developing countries, general practice often acts as a substitute for specialists, with a focus on hospital-based care rather than community health.

Purpose of the Study:

• To explore the diverse roles and evolving identity of general practice globally.
• To identify a common denominator that defines the specificity of general practice across different settings.
• To analyze the influence of historical and systemic factors on the practice of general medicine.

Main Methods:

• Historical analysis of the development of general practice in Western and developing countries.
• Comparative study of general practitioner roles in various healthcare systems.
• Conceptual analysis to define the core principles of general practice.

Main Results:

• General practice has evolved distinct roles, including primary care, secondary care, and health system management.
• Historical exclusion from hospitals and public health shaped general practice towards first-line curative care.
• The primary health care approach, emphasizing a multifactorial and global perspective, offers a unifying concept for general practice.

Conclusions:

• The specificity of general practice lies in its multifactorial approach and global view of health and illness, distinguishing it from specialized care.
• The primary health care approach provides a framework to understand the common identity of general practitioners worldwide.
• The core professional identity of general practitioners is rooted in their attitudes and knowledge, regardless of whether they provide direct care or organize it at a district level.