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Biomedicine Examined pp 227–255Cite as

Thinking Prevention: Concepts and Constructs in General Practice

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Part of the book series: Culture, Illness and Healing ((CIHE,volume 13))

Abstract

General Practitioners (GPs) often report that it is difficult to “think” preventively in the context of their routine consultations with patients; the immediate complaints of the patient are given priority in a clinical encounter and this is reinforced by a long tradition in which being “responsive” to patients’ expressed needs is highly valued. Evidence from recent studies of the content of general practice consultations (Boulton and Williams 1983; Tuckett et al. 1985) shows that prevention does not figure prominently in these transactions, although some have since argued that this overlooks an increasing trend among GPs to raise preventive issues in the consultation (e.g. Stott 1986).1 These findings are at variance with the current ideology of general medical practice in Britain which places considerable emphasis on the notion of anticipatory care as an integral feature of the service GPs provide to patients, and which portrays general practice as a key locus for such activity in the primary care sector (see Royal College of General Practitioners 1981 and 1983).

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References

  • Armstrong, D. 1979 The Emancipation of Biographical Medicine. Social Science and Medicine 131:1–8.

    Google Scholar 

  • 1983 Political Anatomy of the Body. Cambridge: Cambridge University Press.

    Google Scholar 

  • Ashworth, H.W. 1963 An Experiment in Presymptomatic Diagnosis. Journal of the Royal College of General Practitioners, 6, 71.

    Google Scholar 

  • Atkinson, P. 1987 Review of R.A. Hahn and A.D. Gaines (eds.), Physicians of Western Medicine. Social Science and Medicine 24 (19):787.

    Google Scholar 

  • Balint, M. 1957 The Doctor, The Patient and His Illness. London: Pitman.

    Google Scholar 

  • Balint E. and Norell, J. 1973 Six Minutes For The Patient. London: Tavistock.

    Google Scholar 

  • Boulton, M. and A. Williams 1983 Health Education in The General Practice Consultation: Doctor’s Advice on Diet, Alcohol and Smoking. Health Education Journal 42 (2):57–63.

    Article  Google Scholar 

  • Bourdieu, P. 1977 Outline of a Theory of Practice. Cambridge Studies in Social Anthropology, 19. Cambridge: Cambridge University Press.

    Google Scholar 

  • British Medical Association 1950 General Practice and the Training of the General Practitioner. London. British Medical Association

    Google Scholar 

  • 1952 A College of General Practitioners, Report of the General Practice Steering Committee. British Medical Journal 2:1321.

    Article  Google Scholar 

  • Calnan, M. and B. Johnson 1983 Influencing Health Behaviour: How Significant is the General Practitioner? Health Education Journal 42 (2):34–45.

    Article  Google Scholar 

  • Calnan, M. 1984 Clinical Uncertainty: Is It a Problem in the Doctor-Patient Relationship? Sociology of Health and Illness 6:1:75–85.

    Article  Google Scholar 

  • Calnan, M., M. Boulton and A. Williams 1986 Health Education and General Practitioners: A Critical Appraisal. In A. Watt and S. Rodmell (eds.), The Politics of Health Education. London: Routledge and Kegan Paul.

    Google Scholar 

  • Caws, P. 1974 Operational, Representational and Explanatory Models. American Anthropologist 76:1–10.

    Article  Google Scholar 

  • Comaroff, J. 1982 Medicine: Symbol and Ideology. In P. Wright and A. Treacher (eds.), The Problem of Medical Knowledge. Edinburgh: Edinburgh University Press.

    Google Scholar 

  • Coreil, J., J. Levin and E. Jaco 1985 Lifestyle — An Emergent Concept in the Socioedical Sciences. Culture, Medicine and Psychiatry 9:423–437.

    Google Scholar 

  • Crawford, R. 1977 You are Dangerous to Your Health: The Ideology and Politics of Victim Blaming. International Journal of Health Services 7:4:663–680.

    Article  Google Scholar 

  • 1984 A Cultural Account of “Health”: Control Release and the Social Body. In J.B. McKinlay (eds.), Issues in the Political Economy of Health. London: Tavistock.

    Google Scholar 

  • Davies, C. 1984 General Practitioners and the Pull of Prevention. Sociology of Health and Illness 6:3:267–289.

    Article  Google Scholar 

  • Department of Health and Social Security (DHSS) 1976 Prevention and Health: Everybody’s Business. London: Her Majesties Stationary Office.

    Google Scholar 

  • 1977 Prevention and Health: Reducing the Risk: Safer Pregnancy and Childbirth. London: Her Majesties Stationary Office.

    Google Scholar 

  • Doll, R. and R. Peto 1976 Mortality in Relation to Smoking: 20 Years Observations on Male British Doctors. British Medical Journal 2:1525–1536.

    Article  Google Scholar 

  • 1983 Prospects for Prevention. British Medical Journal 286:445–452.

    Article  Google Scholar 

  • Douglas, M. 1970 Natural Symbols. Harmondsworth, England: Pelican Books.

    Book  Google Scholar 

  • 1978 Cultural Bias. Occasional Paper No. 35: Royal Anthropological Institute of Great Britain and Ireland.

    Google Scholar 

  • 1980 Evans-Pritchard. Glasgow: Fontana Paperbacks.

    Google Scholar 

  • Eisenberg, L. 1977 Disease and Illness: Distinctions Between Professional and Popular Ideas of Sickness. Culture, Medicine and Psychiatry 1:9–23.

    Article  Google Scholar 

  • Geertz, C. 1973 The Interpretation of Cultures. New York: Basic Books Inc.

    Google Scholar 

  • Good, B.J. and M.D. Good 1981 The Meaning of Symptoms: A Cultural Hermenuetic Model for Clinical Practice. In L. Eisenberg and A. Kleinman (eds.), The Relevance of Social Science for Medicine. Dordrecht, Holland: D. Reidel Publishing Co.

    Google Scholar 

  • Good, B.J., H. Herrera, M.D. Good, J. Cooper 1985 Reflexivity, Countertransference and Clinical Ethnography. In R.A. Hahn and A.D. Gaines (eds.), Physicians of Western Medicine. Dordrecht, Holland: D. Reidel Publishing Co.

    Google Scholar 

  • Hahn, R. and A. Kleinman 1983 Biomedical Practice and Anthropological Theory. Annual Review of Anthropology, 12: 305–333.

    Google Scholar 

  • Hahn, R.A. and A.D. Gaines (eds.) 1985 Physicians of Western Medicine. Dordrecht, Holland: D. Reidel Publishing Co.

    Google Scholar 

  • Health and Prevention Project 1987 Final Report. London: Health Education Council.

    Google Scholar 

  • Helman, C. 1985 Disease and Pseudo-Disease: A Case History of Pseudo-Angina. In R.A. Hahn and A.D. Gaines (eds.), Physicians of Western Medicine. Dordrecht, Holland: D. Reidel Publishing Co.

    Google Scholar 

  • Horobin, G. and J. McIntosh 1983 Time, Risk and Routine in General Practice. Sociology of Health and Illness 5:3:312–331.

    Article  Google Scholar 

  • Hughes, D. 1977 Everyday and Medical Knowledge in Categorizing Patients. In Dingwall, R., Heath, C, Reid, M., Stacey, M. (eds.), Health Care and Health Knowledge. London: Crom Helm.

    Google Scholar 

  • Jeffreys, M. and Sachs, H. 1983 Rethinking General Practice: Dilemmas in Primary Medical Care. London: Tavistock.

    Google Scholar 

  • Katz, P. 1985 How Surgeons Make Decisions. In R.A. Hahn and A.D. Gaines (eds.), Physicians of Western Medicine. Dordrecht, Holland: D. Reidel Publishing Co.

    Google Scholar 

  • Kleinman, A., Eisenberg, L., Good, B. 1978 Culture, Illness and Care. Annals of Internal Medicine 88:251–258.

    Google Scholar 

  • Kleinman, A. 1980 Patients and Healers in the Context of Culture. Berkeley: University of California Press.

    Google Scholar 

  • Labonte, R. and S. Penfold 1981 Canadian Perspectives in Health Promotion: A Critique. Health Education. April: 4–8.

    Google Scholar 

  • Lazare, A. 1973 Hidden Conceptual Models in Clinical Psychiatry. New England Journal of Medicine 288:345–351.

    Article  Google Scholar 

  • Lock, M. 1985 Models and Practice in Medicine: Menopause as a Syndrome or Life Transition? In R.A. Hahn and A.D. Gaines (eds.), Physicians of Western Medicine. Dordrecht, Holland: D. Reidel Publishing Co.

    Google Scholar 

  • McWhinney, I. 1964 The Early Signs of Illness. London: Pitman.

    Google Scholar 

  • Pendelton, D., T. Schofield, P. Tate, P. Havelock 1984 The Consultation: An Approach to Learning and Teaching. Oxford: Oxford University Press.

    Google Scholar 

  • Pill, R. and N. Stott 1982 Concepts of Illness Causation and Responsibility: Some Preliminary Data From a Sample of Working Class Mothers. Social Science and Medicine 16:43–52.

    Article  Google Scholar 

  • Roland, M. 1986 The Family Doctor: Myth or Reality. Family Practice 3 (3): 199–204.

    Article  Google Scholar 

  • Royal College of General Practioners 1981a Health and Prevention in Primary Care, 18. London: RCGP Report from General Practice.

    Google Scholar 

  • 1981b Prevention of Arterial Disease in General Practice, 19. London: RCGP Report from General Practice.

    Google Scholar 

  • 1981c Prevention of Psychiatric Disorders in General Practice, Report from General Practice, 20. London: RCGP Report from General Practice.

    Google Scholar 

  • 1981d Family Planning — an Exercise in Preventive Medicine, Report from General Practice, 20. London: RCGP Report from General Practice.

    Google Scholar 

  • 1982 Healthier Children — Thinking Prevention, Report from General Practice, 22. London: RCGP Report from General Practice.

    Google Scholar 

  • 1983 Promoting Preventive Medicine, Occasional Paper, 22. London: RCGP Report from General Practice.

    Google Scholar 

  • Shapin, S. 1979 Homo Phrenologicus: Anthropological Perspectives on an Historical Problem. In B. Barnes and S. Shapin (eds.), Natural Order. London: Sage Publications.

    Google Scholar 

  • Smail, S. 1982 Opportunities for Prevention: The Consultation. British Medical Journal 281:231–5.

    Google Scholar 

  • Stimson, G. 1976 General Practitioners, Trouble and Types of Patients. In M. Stacey (ed.), The Sociology of the NHS. University of Keele: Sociological Review Monograph 22.

    Google Scholar 

  • Stott, N.C. and Davies, R.H. 1979 The Exceptional Potential in Each Primary Care Consultation. Journal of the Royal College of General Practitioners 29:201–205.

    Google Scholar 

  • Stott, N.C. 1983 Primary Health Care. Berlin: Springer Verlag.

    Google Scholar 

  • 1986 The Potential for Health Education in Primary Health Care. In M. Boulton and A. Williams (eds.), Health Education in General Practice. London: Health Education Council.

    Google Scholar 

  • Tuckett, D., Boulton, M., Olson, C. and Williams, C. 1985 Meetings Between Experts: An Approach to Sharing Ideas in Medical Consultations. London: Tavistock.

    Google Scholar 

  • World Health Organization (WHO) 1978 Declaration of Alma Ata. Report on the International Conference on Primary Health Care, Alma Ata, USSR. Geneva.

    Google Scholar 

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Authors
  1. Anthony Williams
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  2. Mary Boulton
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Editor information

Editors and Affiliations

  1. Departments of Humanities and Social Studies in Medicine and Anthropology, McGill University, Montreal, Canada

    Margaret Lock

  2. Program in Medical Anthropology, University of California, San Francisco, USA

    Deborah Gordon

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© 1988 Kluwer Academic Publishers

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Williams, A., Boulton, M. (1988). Thinking Prevention: Concepts and Constructs in General Practice. In: Lock, M., Gordon, D. (eds) Biomedicine Examined. Culture, Illness and Healing, vol 13. Springer, Dordrecht. https://doi.org/10.1007/978-94-009-2725-4_10

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  • DOI: https://doi.org/10.1007/978-94-009-2725-4_10

  • Publisher Name: Springer, Dordrecht

  • Print ISBN: 978-1-55608-072-2

  • Online ISBN: 978-94-009-2725-4

  • eBook Packages: Springer Book Archive

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