Working Fields and Prevention Domains
in General Practice / Family Medicine

Draft Version 0.6        

Marc Jamoulle1, Michel Roland2, Niels Bentsen3, Michael Klinkman4, Erik Falkoe5, Bob Bernstein6, Anders Grimsmo (?), Yamada Takashi (?),.., on behalf of the WONCA International Classification Committee

Family physicians.
1&2 Family Medicine and Primary Care Unit, Public Health School, Free University of Brussels (Be)
3 Department of Community Medicine and General Practice University of Trondheim (No) & Chairman, WONCA International Classification Committee
4 Department of Family Medicine, University of Michigan (US)
5 Research Unit of General Practice, University of Southern Denmark, Odense (Dk)
6 Department of Family Medicine, University of Ottawa (Ca)
Contact :

Points 1,3 and 4 have to be written following the suggested themes

  • Implementing quaternary prevention, opening research fields

    • Limiting iatrogenic harm
    • Accepting and legitimating the patient suffering
    • Naming the illness appropriately
    • Recognizing and tolerating uncertainty
    • Simultaneously exploring symptoms, pathological findings,
      life context, and emotions, in all cases
    • Finding meaningfull language
    • Addressing the body
    • Treating symptoms and improving functioning
    • Adressing the physician needs
    • Creating health system conductive to care

    Table 7 Principles of care. Reproduced from Epstein, Quill and Mc Whinney
    (permission asked)

  • References

  • Aknowledgement

    Thanks to B. Starfield, F. Mennerat, Ph. Sive and R. Lagasse for valuable comments and to Margaret Leemans and Guy Kervyn for helping in the translation.

    Remaining bibliography to be included (of which I have the reprint)

    Barsky AJ, Wyshak G, Klerman GL. Psychiatric morbidity in DSM-III-R Hypochondriasis. Arch.Gen.Psychiatry. 1992 Feb; 49: 101-8

    Guttman N, Kegler M, McLeroy KR. Health promotions paradoxes, antinomies and conundrums (Editorial). Health education research. 1996 March;11(1):i-xiii

    McWhinney IR. Why we need a new clinical method. Scand J Prim Health Care. 1993 Mar;11(1):3-7.

    Rochon PA, Gurwitz JH. Optimising drug treatment for elderly people: the prescribing cascade. BMJ. 1997 Oct 25;315(7115):1096-9.

    Rogers J. Clinical preventive medicine: primum non nocere? J Fam Pract. 2000 May;49(5):442-5.

    Snadden D. Ethical Dilemmas of cervical cancer screening. Can Fam. Phys. 1992 Feb.;38 : 331-3

    Stern J, Murphy M, Bass C. Attitudes of British psychiatrists to the diagnosis of somatisation disorder. A questionnaire survey. Br J Psychiatry. 1993 Apr;162:463-6.

    Wensing M, Jung HP, Mainz J, Olesen F, Grol R. A systematic review of the literature on patient priorities for general practice care. Part 1: Description of the research domain. Soc Sci Med. 1998 Nov;47(10):1573-88