Is primary-care research a lost cause?

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Primary-care researchers have voiced concerns that their discipline is complex, and that as researchers they are misunderstood by academia, funding bodies, and journal editors; they have also highlighted a need to create a boundary around their discipline to create a unique knowledge base. The editorial disagrees: 'The great strength of primary care is that it does not have a boundary. Family practice offers a perspective that should influence all other clinical specialties. In sum, if primary care has anything at all to do with improving a person's health, then its contribution to that end will be measurable. Or is primary care to be accepted as the homoeopathy of modern medicine-incontestable, irreducible, and, ultimately, irredeemable?'

The editorial concludes: 'A particular focus for inquiry should surely be the family. If general practice does have any claim to uniqueness, it comes closest when thinking about the family-the vital context of most personal illness in the community. That context has changed dramatically during the past decade-economically, socially, educationally, and sexually. There is now a diversity of family forms-single, one-parent, same-sex, double-income-which influences the way in which, for example, illness presents. Previously hidden epidemics of mental ill-health and domestic violence both have critical family contexts. And as peoples migrate across continents as well as nation-states, the impact of culture on medicine becomes ever more important.'