Alternative, science-based definition

Although I am very proud of the contributions the authors of the Besrour Papers series are making to the profession, I profoundly disagree with their putative definition of family medicine as a discipline.¹

For me, the definition is not social but scientific. Family medicine is the practice of general medicine for all ages in a context of low prevalence of disease, multiple accumulating comorbidities, and an ongoing doctor-patient relationship. Respect for the epidemiology of general practice is paramount and it is what sets us apart from specialists who treat body systems. We treat the whole patient—all their diseases—in addition to providing prevention and screening. We see patients over time. We see symptoms evolve—either resolving or mutating into diseases. We manage multiple comorbidities where evidence is scanty. We should recognize comorbidity as an urgent area of research in family medicine.

It is this scientific approach that I believe is necessary to gain and maintain respect within the larger medical community. We are not just relationship oriented. Relationships with specialists and patients are important but not sufficient. We practise scientific generalism over time, with a known, defined group of patients as a practice denominator.

I do not know or understand what the term family physician actually means, as the definition of family is so fluid. I consider myself a generalist physician and wear the label GP proudly.