Wonca Europe 2023 Definition of General Practice/Family Medicine: New Needs New Content

To the Editor: In 2023, the new definition of general medicine,¹ authored by Wonca Europe, was released. This is not the first attempt, as other proposals have been introduced in the past, such as the Leeuwenhorst group’s (1974), which occurred during general practice’s infancy in terms of education and research. The Wonca’s (1991) and Olesen’s (2000) definitions that followed have strong ties to the Leeuwenhorst’s definition. Definitions were also provided by the Wonca Europe: The 2002 definition established both the field of general practice/family medicine and the responsibilities of family doctors, while outlined the essential competencies expected of general practitioners; the 2005 definition aimed at enhancing clarity; and the 2011 definition introduced 2 new concepts: patient empowerment and continuous quality improvement.

The definitions received criticism, as they are filled with technical terminology and were nearly incomprehensible to those outside the field.² Furthermore, it was emphasized that existed a necessity for clarification.³

The 2023 version largely replicates the content of the previous definitions. It provides a comprehensive definition of general practice/family medicine, encompassing the professional tasks of family doctors, and highlighting the core competencies required by general practitioners. In addition, it includes an explanation of the underlying reasoning and detailed academic analysis. Furthermore, this version emphasizes the importance of one Health, Planetary Health, and Sustainability in the field of general practice/family medicine, which are emerging concepts in the discipline.

The European definition of general practice/family medicine had a fundamental impact on shaping the discipline by defining its content, research domains, and its role in the twenty-first century.⁴ It enhances the comprehension of the general practitioner's role, as perceived by general practitioners themselves and allied health professionals, as well as by health care planners, politicians, and the public. It contributes to the promotion and development of the discipline, striving to achieve and uphold exceptional standards of education, training, research, and clinical practice, all with the ultimate aim of benefiting individual patients and communities.¹ In addition, it proves to be a highly valuable tool when engaging in discussions with policy makers, educators, media representatives, and even doctors themselves.¹

The existence of the definition inevitably rises particular thoughts: Unlike other specialties with self-explanatory content, general medicine necessitates a precise definition. The development of this definition is a challenging endeavor, due to the unique characteristics of the discipline (use of an inclusive, holistic, and continuous approach)³ and due to the substantial variations in the practice of family medicine across various European regions.

By studying the evolution of the definitions, we witness the gradual advancement and maturation of the discipline. Its role undergoes a process of evolution, transitioning from an initially vague state to a well-defined one. Wonca Europe effectively monitors the current epistemological and social developments, ensuring regular updates to the definition.

Without a doubt, family medicine will continuously evolve to align with the health needs of communities and health systems.⁵ Consequently, in the future there will be a need for additional revisions. In closing, we acknowledge that the definition of general medicine can serve as an inspiration, a matter for contemplation, and a motivation for action and future preparation.¹