General practice is a complex and challenging specialty, requiring understanding of, and proficiency in, numerous overlapping concepts and skills. First and foremost, general practitioners (GPs) must practise patient-centred care, recognising the patient as a partner in their own healthcare and people as unique individuals rather than conditions to be treated.1
Key to whole-person care is considering the multiple dimensions of the patient in an integrated way, underpinned by the patient–doctor relationship. Whole-person care recognises patients as individuals, acknowledges the humanity of the doctor, views health as more than just the absence of disease, employs a range of treatment modalities and places importance on the therapeutic relationship.2
The nature of general practice means that GPs must be particularly skilled in verbal and non-verbal communication.3 A good GP can adapt their communication and consultation styles to the person in front of them. This has the flow-on effect of ensuring the realisation of the patient’s agenda, improving concordance with treatment and improving health outcomes.4 This also allows for effective history taking, which is fundamental and offers the most valuable information in most presentations. It is also important for GPs to acknowledge the significance of practising culturally sensitive care, and to recognise the importance of providing safe spaces within their clinics, particularly for their Aboriginal and Torres Strait Islander and culturally and linguistically diverse patients.
General practice involves seeing the broadest range of conditions across any specialty, requiring GPs to possess a significant breadth of knowledge. A GP must have good working knowledge of 167 problems to cover 85% of the conditions they will see most frequently.5 Uncertainty, unpredictability and undifferentiated presentations are common challenges of general practice,6 so GPs must feel comfortable dealing with uncertainty, have an approach to managing it and communicate this appropriately to their patients.6 GPs should have finely honed investigative skills for the wide variety of conditions they see in day-to-day practice. This necessitates traversing the fine balance between ordering investigations in such a way that important pathologies are not missed, while avoiding over-investigation. A growing body of evidence suggests that over-testing is a significant problem, with many potential adverse consequences.7 GPs must be able to interpret the results of investigations in the broader context of the patient.
GPs need a holistic approach to management that is orientated to empowering patients to make their own health management decisions. This requires understanding the various pharmacological and non-pharmacological therapeutic options for an extensive range of conditions and being able to effectively communicate these to the patient. GPs must also have a keen understanding of pharmacokinetics, being able to safely prescribe for patients, some of whom might be on multiple medications, and appropriately counsel patients on this. A good GP knows how to integrate pharmacological and non-pharmacological options for a patient in a way that is adapted to their unique needs and is evidence based.
GPs manage patients who are seriously unwell, in the community and in hospital settings, and GPs will be called on to stabilise these patients. These patients might or might not then require transfer to another clinician and/or facility for further care. GPs must be able to engage collaboratively with a wide variety of healthcare providers, knowing when to refer, communicating well, ensuring follow up and working successfully within a team.