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

In a recent letter, Garcia-Huidobro, Prasad, and von Pressentin emphasized the distinction between General Practice and Family Medicine.¹ According to them, general practitioners are primary care physicians who have completed medical school but have not pursued additional specialized training. In contrast, family physicians undergo further training and earn certification through residency programs or supervised internships. The terminology varies in my country and possibly in other European countries, which contributes to the confusion.

In Greece, physicians are categorized into 2 groups: those without a specialty (medical school graduates without further training, a small minority) and specialists (the vast majority). Although it may seem unusual to some, General Practice is officially recognized as a medical specialty. Canada's experiencing something similar,² I think. Medical school graduates must complete a 5-year residency program to qualify as general practitioners. Due to their extensive training, general practitioners possess greater knowledge and skills than doctors without a specialty, justifying their classification as specialists. While doctors without a specialty can practice primary care, they do so with lower salaries and certain restrictions.

Further complicating the issue, the term “Family Doctor” refers to a role within the health care system rather than a specifically trained physician. It simply designates a doctor responsible for family care, regardless of his formal education. Due to a shortage of full trained general practitioners, the government is considering allowing physicians from other specialties, such as internists, to serve as family doctors after completing a short training program. It is known that there are substantial variations in the practice of family medicine across various European regions.³ We have to add that even the terminology used varies considerably. A valuable pursuit would be to explore how other countries define and use the terms “general practice” and “family medicine.”

Doctors without specialization, fully trained general practitioners (family physicians according to authors terminology), and occasionally specialists from other fields all contribute to family care, but they differ in knowledge,⁴ skills, approaches,⁵ and outcomes.⁴ The authors suggest revising the discipline's definition to clarify these differences, emphasizing the benefits of additional training of physicians, though this may lead to negative consequences like interprofessional conflicts.⁶ The proposal's potential benefits, risks and the implementation approach require careful consideration.