The pace of innovation in medical research means that doctors have to be customers of lifelong learning. They cannot cope without keeping abreast of new biomedical understanding and the new treatments it produces.
But a study of general practitioners in action suggests that new scientific knowledge can be a problem as well as a solution. During their training, insights into individuals have less status than science-based findings, preferably from large population samples. During their working lives, their practice-based medicine has less prestige than that done in science-oriented hospitals, especially teaching hospitals.
One result is that GPs are obliged to improvise their way through patient problems, such as widespread mental disturbance, that can all too easily start to affect doctors themselves. Medics have long ignored their own advice on the evils of alcohol, but rising suicide rates are an unwelcome trend. With some exceptions, medical schools have undervalued and done too little research into general practice. They should think harder about how to make GPs' wisdom more valued, their role more prestigious and their work more bearable.
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