A New Systematic Approach to Problems in General Practice and Its Consequences for Research

Abstract: Medical research finds its Legitimation by improving the conditions of everyday life of sick people. Apart from purely biological effects, a lot of influence factors contribute to the outcomes of medical interventions in terms of 'social effectiveness' for the patient. These may concern the way a doctor or the medical system tackles the patient's problem as well as the relevant social and psychological conditions, the factors referring to work or family, and the patient's personality, health beliefs, expectations etc. Thus a specific transformation process must take place in order to achieve a real health gain as perceived by the patient. Until now medical research has developed impressive new therapeutic principles, however, it has widely neglected the processes of transfer and implementation and the field of its effectiveness for the patient apart from the biological effects. It still remains poorly understood that the confrontation of medical endeavours with the patient's life situation provokes a process of conflict and adaption which essentially contributes to the success or failure of medical practice. Here new fields of research for general practice arise. We should investigate the principles examining the effectiveness of medical interventions in the area of conflict between medicine and patient and the general practitioner's mediatory role in this process. This field of research is determined by the coordination of the following three elements forming a primary care scheme of action: 1. hierarchy of general therapeutic goals, 2. primary care description of health problems, 3. dimensions of possible help.

Keyword(s): Forschung in der Allgemeinmedizin

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