Family medicine: The classic papers
Edited by Michael Kidd, Iona Heath, Amanda Howe.
CRC Press, Taylor & Francis Group New York, 2017
People who work hard understand the concept of discipline. That is, an organised branch of knowledge that provides a means to achieving an end. So what happens when you ask dedicated general practitioners (GPs) from around the world about key primary care medical discoveries that have inspired them to improve the quality of medical care to our community? The result is this collection of landmark papers detailing the history, breadth and foundational paradigms of general practice.
Each of the contributors of Family medicine: The classic papers were asked to nominate one journal article that they felt has had the greatest impact on family medicine development. They were also asked to discuss why the paper is important to them and to provide a few words of advice that they would have liked to have heard at the beginning their careers. While this might possibly have resulted in some fairly personal views, the result is actually a comprehensive overview detailing the development and the intellectual infrastructure of primary care medicine.
From the individual practitioner to the clinic, from the philosophical to the scientific and from humanism to evidence-based medicine, these papers provide an opportunity to reflect on, and also to be proud of, the achievements of the profession.
Starting with the wonderful short story from Conan Arthur Doyle, the reader is soon in ground-breaking areas: the insightful and prophetic Collings Report that changed the face of general practice; McWhinney on problem-solving and decision-making in family medicine; and the more recent Starfield et al, which firmly established the key contribution of primary care to the health system.
Reading this collection, you may discover gaps in your knowledge well worth visiting. I personally learned much from the papers relating to primary care medicine around the globe. As well as being enlightening in their own right, they also reinforced the universality of the principles of the general practice profession across a wide variety of social, cultural and geographical contexts.
You will also find papers that canonised key differentiating features of the speciality of general practice from other medical specialities, including dealing with the uncertainty of first patient contact, diversity of disease presentations, and the management of chronic diseases and multimorbidities.
You will find evidence here that has resulted in the increasing recognition of the central role of general practice in improving health outcomes for the general population as well as the importance of prevention in the general practice setting.
An underlying theme that goes through many of the papers is the role that social inequity plays in health, and the GP’s role in addressing this in their daily work.
Don’t miss the advice each contributor would have given to their younger self – there are some gems there that will be of particular use to new starters in general practice who should also find the entire volume a sound introduction to the foundation of their new profession.
So much of the history of general practice is about organisations outside of the profession, such as governments, educational institutions and other health professions trying to define what general practice is and is not. Family medicine: The classic papers evocatively details the rich philosophical, scientific and humanistic basis of our profession.
With its expansive perspective of thought, grab this book, take time out and take stock. Take a journey through the vista of the profession’s wisdom and have a good think.
It will make you a better GP.
Dr Ronald McCoy Education Strategy Senior Advisor, RACGP; Adjunct Lecturer, Central Clinical School, University of Sydney