Disciplines within general practice.
The disciplines within general practice derive partly from its community setting, and partly from the nature of professional expertise. The maladies range from a high prevalence of low risk, self-limited illness to a low prevalence of high risk, persistent disease. Each set calls on different knowledge and skills. The setting offers the substrate for studying social and behavioural sciences and community health development in action. Choosing a few particular fields, and developing those with rigour, could strengthen general practice as a discipline with special insights and skills to offer all branches of clinical practice. Four fields of activity have been identified. In each, general practice has a clear responsibility and opportunity. I have suggested some knowledge and skill areas for their success--clinical 'working' knowledge, decision making and judgment, predictive knowledge, planning knowledge, calibration of investigators, intuitive knowledge, local knowledge, leadership skills and people management, measurement of burden of illness, calculation of cost-benefit trade-offs, building of local databases, re-learning fine discrimination in clinical perception, and understanding of community development. These subjects have not been part of formal medical education, or of much academic study in family practice. Despite their being central to the success of daily practice, the curriculum is silent about the study of these areas of practical knowledge, reasoning, judgment and skill. Worse, we do not have a common language to express clearly what we are talking about. Experience and skill lie within the practitioner, and are used in practical, concrete situations.(ABSTRACT TRUNCATED AT 250 WORDS)
Cox
K
K
School of Medical Education, University of New South Wales.
D005194:Family Practice; D006801:Humans