TY - JOUR T1 - A crisis of identity: what is the essence of general practice? JF - British Journal of General Practice JO - Br J Gen Pract SP - 246 LP - 247 DO - 10.3399/bjgp21X715745 VL - 71 IS - 707 AU - Rupal Shah AU - Sanjiv Ahluwalia AU - John Spicer Y1 - 2021/06/01 UR - http://bjgp.org/content/71/707/246.abstract N2 - The past 40 years have brought changes that have transformed general practice as we used to understand it. Despite this, as a profession, we like to imagine that the clinician–patient interaction remains centre stage, played out in time and space as close as possible to the communities where individuals live, influenced by their social contexts. However, this archetypal description of general practice is challenged by fundamental uncertainties about our role and purpose, which we explore below. These uncertainties test our conception of relational care and our ability to enter into the therapeutic alliances that we know benefit patients.As far back as 2004, Ronald Barnett described a conflict in the identity of universities whereby it isn’t clear whether they serve to ‘consume and produce resources’ or to act as ‘centres for the promotion of critical thinking and transformatory engagement’.1 It is our assertion that a similar paradox exists in general practice, where we are faced with the dilemma of whether our role is to ensure patient safety by following guidelines, in such a way as to minimise risk; or whether it is to co-create meaning with our patients, to help them navigate a path through their illness and to accept that this can be a risky undertaking, both for them and for us. These two views of the profession are fundamentally misaligned.An important contributory factor to the uncertainty about purpose in general practice has been … ER -