A filosofia da Medicina de Família e Comunidade segundo Ian McWhinney e Roger Neighbour

Beatriz Ramirez Jaco; Armando Henrique Norman

doi:10.5712/rbmfc15(42)1991

Authors

Beatriz Ramirez Jaco Escola de Saúde Pública da Secretaria Municipal de Saúde de Florianópolis, Florianópolis, Santa Catarina, Brasil. https://orcid.org/0000-0003-0399-8964
Armando Henrique Norman Universidade Federal de Santa Catarina, Florianópolis, Santa Catarina, Brasil. https://orcid.org/0000-0002-5267-7377

DOI:

https://doi.org/10.5712/rbmfc15(42)1991

Keywords:

Primary Health Care, Philosophy, Family and Community Medicine, Internship and Residency, Medical Education

Abstract

Introduction: This article revisits the philosophical assumptions of Family and Community Medicine (FCM) from Ian McWhinney’s and Roger Neighbour’s writings. Objective: To strengthen the discussion on the theoretical foundations of FCM both in the academy and in residency programmes in FCM. Methods: This is a reflexive essay that compares and analyses two of the main books on FCM: the classic “Textbook of Family Medicine” by Ian McWhinney and “The inner physician: why and how to practise ‘Big Picture Medicine’” by Roger Neighbour. Results and Discussion: Ian McWhinney and Roger Neighbour apply the epistemology of Thomas Kuhn to propose a different paradigm to medicine. In this process, the authors developed distinct but complementary proposals that we decided to categorise into: (a) McWhinney’s organismic paradigm and Neighbour’s quantum paradigm; (b) a distinction between general practitioner and focal specialist; and (c) doctor-patient relationship and with itself. Conclusion: To navigate the uncertainties of general practice, it is necessary to nurture and reflect on the essence of FCM, both in undergraduate courses and in residency programmes, to train professionals sensitive to the human condition.

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References

(1). McWhinney IR, Freeman T. Manual de Medicina de Família e Comunidade. 3ª ed. Porto Alegre: ARTMED; 2010.

(2). Starfield B, Shi L, Macinko J. Contribution of primary care to health systems and health. Milbank Q. 2005;83(3):457-502. DOI: https://doi.org/10.1111/j.1468-0009.2005.00409.x DOI: https://doi.org/10.1111/j.1468-0009.2005.00409.x

(3). Franks P, Clancy CM, Nutting PA. Gatekeeping revisited — protecting patients from overtreatment. N Engl J Med. 1992;327(6):424-9. DOI: https://doi.org/10.1056/NEJM199208063270613 DOI: https://doi.org/10.1056/NEJM199208063270613

(4). Norman AH, Tesser CD. Prevenção quaternária: as bases para sua operacionalização na relação médico-paciente. Rev Bras Med Fam Comunidade. 2015;10(35):1-10. DOI: https://doi.org/10.5712/rbmfc10(35)1011 DOI: https://doi.org/10.5712/rbmfc10(35)1011

(5). Pimlott N. Reflecting on Dr. Ian McWhinney. Can Fam Physician [Internet]. 2012; [2019/ fevereiro/ 15]; 58(11):1187-8. Disponível em: http://www.ncbi.nlm.nih.gov/pubmed/23152451

(6). Neighbour R. The Inner Consultation: how to develop an effective and intuitive consulting style. Abingdon, UK: Radcliffe Publishing; 2005.

(7). Neighbour R. The inner apprentice: an awareness-central approach to vocational training for general practice. Abingdon, UK: Radcliffe Publishing; 1992.

(8). Neighbour R. The Inner Physician: Why and How to Practise “Big Picture Medicine.” London, UK: Royal College of General Practitioners; 2016.

(9). McWhinney IR. A Textbook of Family Medicine. 2nd ed. New York: Oxford University Press; 1997.

(10). Kuhn TS. The structure of scientific revolutions. 2nd ed. Chicago: University of Chicago Press; 1970.

(11). McWhinney IR. Being a general practitioner: what it means. Eur J Gen Pract. 2000;6(4):135-9. DOI: https://doi.org/10.3109/13814780009094320 DOI: https://doi.org/10.3109/13814780009094320

(12). McWhinney IR. Why we need a new clinical method. Scand J Prim Health Care [Internet]. 1993 Mar [2019/ fevereiro/ 15]; 11(1):3-7. Disponível em: http://www.ncbi.nlm.nih.gov/pubmed/8484077 DOI: https://doi.org/10.3109/02813439308994894