This fourth edition of Common Diseases comes just over 10 years after
the first. There has been change and counterchange in the primary health
care (PHC) field. One change has been the tendency to replace 'general
practice' by 'PHC'. Vocational training has become compulsory. With
larger group practices have come formalized teams and teamwork,
increasing con- cern with the business side of general practice and
attempts to achieve best values for money and maximal profits. On the
clinical side there have been enthusiasms for prevention, early
diagnosis, anticipatory care, screening and quality initiatives. As a
counterchange it is necessary to remind ourselves that the real essence
of general practice, PHC, or whatever title we give it, is 'personal
doctoring' of people as individuals in family units. All the changes
mentioned will achieve less than expected without good continuing
doctor/ patient personal care. But even this is not enough. Good general
practice demands a sound knowledge of the nature of disease in the
community. Not only are traditional diagnostic and therapeutic skills
necessary, but also application of an understanding of the frequency and
distribution of the diseases and an awareness of their likely natural
history - their course and outcome.
