TY - JOUR T1 - A taxonomy of general practice JF - British Journal of General Practice JO - Br J Gen Pract SP - 386 LP - 388 VL - 56 IS - 526 AU - Kieran Sweeney AU - Iona Heath Y1 - 2006/05/01 UR - http://bjgp.org/content/56/526/386.abstract N2 - BACKGROUNDMrs B was 84 years old, when her GP, who had known her for a decade and a half, was asked to see her. Mrs B had been widowed for 5 years, following the sudden death of her husband, Jack. Her two adult sons had been a disappointment to her: both were in and out of prison for repeated minor criminal offences. The practice nurse had asked the doctor to see her, after looking at her blood test results. Below, we show Mrs B's multiple and compounding conditions, and the results of her most recent tests, which sparked the consultation.View this table:In this windowIn a new windowThe doctor rehearsed with Mrs B the abundant evidence supporting interventions to improve all her biochemical parameters. There was evidence, the doctor said confidently, to support changes in her medication, changes in her diet, and maybe, if she felt like it, changes in her lifestyle. Mrs B listened carefully to the doctor, and then remained quiet for a moment. After a while, she spoke. ‘Well’, she said, ‘Jack's dead, and the boys have gone.’GPs are clinical generalists, taught to recognise context and respect patient values, aware of their ability to influence patients through the subtleties of their interaction with them.1 While this is known, much less has been written about the theoretical principles behind, and implications of, these features of general practice. In this essay, we try to theorise about what it is in the features that is intellectually important and practically relevant. We explore technical general practice, asserting its importance as a versatile and health-economically important commodity. We look at what it means to ‘recognise the importance of context’ in terms of different ways of knowing about, and gazing upon, the world. And when we discuss the concept of the doctor as the drug, we are driven … ER -