GENERAL PRACTICE : THE CORNERSTONE OF HEALTH CARE IN THE THIRD MILLENIUM

Abstract

As we move into the third millennium, it is clear that the World Health Organisation
(WHO) goal of “Health for All†is yet to be achieved. Nowhere is this more evident
than in developing countries like Nepal where the majority of people live in rural
areas, many of them caught in the poverty-ill health-low productivity downward spiral.
In recent decades, most programs aimed at improving population health outcomes
have been designed and delivered with little or no involvement of medical practitioners
other than specialists in specific diseases or population/public health.
General practice is the medical discipline which involves the provision of continuing,
comprehensive, community-based patient-centred prevention-oriented primary care.
General practitioners are at the interface between: low technology/low cost and high
technology/high cost care; medical and non-medical health and welfare services; and
individual care for illness, injury or disability and community/population health
approaches to improving health status. This places general practice and general
practitioners in a pivotal position to provide individuals and families with timely cost-effective care, and to provide leadership in the development and implementation of
health care systems which are responsive to community and societal needs.
Since 1994, the WHO and WONCA, the World Organisation of Family Doctors, have
been working together first through a landmark Invitational Conference and Report
on “Making Medical Practice and Education More Relevant to People’s Needs: The
Contribution of the Family Doctorâ€, and more recently through a Memorandum of
Agreement and the Towards Unity for Health (TUFH) Project. TUFH promotes efforts
worldwide to create unity in health service organisations particularly through
sustainable integration of medicine and public health, individual health and community
health related activities. Achievement of “Health for All†will require development of
balanced, affordable and sustainable health care systems which build on the broad
expertise of general practitioners and general practice.