Abstract

Available from UMI in association with The British Library. ;This thesis traces endeavours in the twentieth century to provide the 'intellectual' foundations for general medical practice as an independent, autonomous clinical discipline. The empirical focus of the study is upon the application of psychological and 'person-centred' approaches to general practice; above all, in the work of Michael Balint, and the Royal College of General Practitioners in the post-war period. The thesis is guided by two predominant theoretical concerns. First, to highlight the complex strategies and the wide range of means and resources that have been required to give substance to the claim that general practice is 'by nature' a person-centred endeavour. Second, to consider--and to question--certain influential approaches to medical power in general, and to the social consequences of 'emancipatory'--person-centred--forms of medicine in particular. Specifically, the 'power/knowledge' approach to medical sociology is contested both with regard to its empirical findings and in relation to its basis in the work of Michel Foucault . ;The study which follows is intended neither as a narrative history of general practice nor as a history of ideas about general practice. Its empirical concern is more specific than either of these. Focusing upon the twentieth century and above all the post-war period, it seeks to analyse some of the ways in which general practitioners have sought to autonomise their discipline by giving it an 'intellectual' basis. If the 'general practitioner' has long existed as a professional label then nevertheless notions of what unifies the general practitioner's activities have undergone a degree of mutation. It is these 'models' of general practice--physiological, epidemiological, psychological--which will be investigated here. As such, the purpose behind the study is partly of a 'methodological' order. The study seeks to show that what counts in evolving a coherent model of general practice is not just the provision of a 'representation' of the general practitioner's activities but a construction on several levels