The Ecology of General Practice in South Africa: Part II

Abstract

In this paper it is argued that General Practice in South Africa has to be understood in relation to the broader health and Societal context of which it forms part in a manner analogous to a biological organism whose survival and functioning is inextricably bound up with its environment. Part I of the paper deals with the relationship between general practice and other fields of health care eg. Community Health. The lack of understanding between medical disciplines is viewed against the backdrop of inappropriate training at medical schools. It is argued that most medical graduates are not trained to become involved in thinking about, debating and contributing towards the resolution of health issues in South Africa. Two illustrative examples in support of this view are cited. Part II of the paper begins by discussing the deliterious effects of primary and secondary school education on prospective doctors. The concept of Community-Based Medical Education (CBME) as an alternative to existing forms of medical education is discussed, with particular reference to its potential for ensuring the increased relevance of such training to national health priorities, and the contribution which General Practice in South Africa could make to CBME. It is argued that from an ecological perspective, the organism which is general practice will need to remain flexible, and its adherents will have to have the courage to question themselves constantly in order to remain viable and relevant in South African society.