The role of socio-behavioural scientists in health care practice

This paper attempts to analyse some of the complex problems that face primary health care practice in the developed world today. These are shown to be a degree of depersonalisation, that has come with greater efficiency, and a reduction in the quality of the doctor-patient relationship, which has accompanied increased medical effectiveness. These changes are in turn related to changes in diagnostic methods in primary care, to changes in the organisation of primary care and to change in the stress laid on interventive, preventive and rehabilitative care. All these inter-related problems have to be viewed against a background of shortage of resource which demand a far more stringent system of accountability than has been common until now. A possible solution lies in redefining the traditional medical role and the philosophical basis which underlies that role at a time when primary health care is confronted by thespecial problems of the AIDS pandemic. This would require major alterations in medical attitudes and in established medical education which may be impossible for the doctors to achieve by themselves. It is suggested that a most important role of socio-behavioural scientists lies in helping the medical profession to remove the attitudinal and educational barriers which prevent the realisation of the concept of a new sort of doctor who may cope with the demands of primary health care as we approach 2000.