A sustainable vision for general practice: Understanding the challenges.

BACKGROUND: The COVID-19 pandemic has revealed the full extent of the crisis in general practice, which has emerged as nothing more than the tip of the iceberg of a health system in crisis. OBJECTIVE: This article introduces the systems and complexity thinking that frame the problems affecting general practice and the systemic challenges inherent in redesigning it. DISCUSSION: The authors show how embedded general practice is in the overall complex adaptive organisation of the health system. They allude to some of the key concerns that need to be dissolved in its redesign to achieve an effective, efficient, equitable and sustainable general practice system within a redesigned overall health system to achieve the best possible desired health experiences for patients.

A sustainable vision for general practice: Addressing the challenges

BACKGROUND: The systemic problems and challenges of general practice within the health system require systemic solutions. OBJECTIVE: Noting the complex adaptive nature of health, illness and disease, and its distribution within communities and general practice work, this article suggests a model for general practice that allows the full scope of practice to be developed while creating seamlessly integrated general practice colleges that support general practitioners on their journey to 'mastery' in their chosen discipline. DISCUSSION: The authors discuss the complex dynamics underpinning knowledge and skills development throughout doctors' careers, and the need for policy makers to evaluate health improvement and resourcing based on their interdependencies with all societal activity. To succeed, the profession would have to adopt the principles that form the foundation of generalism and complex adaptive organisations to strengthen its ability to successfully interact with all its stakeholders.