[General practice: a theme in search of clarity].

Specialization is a consequence of the progress in knowledge and technology, and is essential to increase medical knowledge. Culturally, the population increasingly aspires to be attended by a specialist. On the other hand, generalism is necessary to protect the unitary focus on the sick patient, to mitigate the increasing cost of medicine and to avoid the increasing dehumanization of medical practice. The condition of generalist is not synonym of general practitioner and may be applied to internists or pediatricians with ample knowledge and diagnostic skills based more in medical interview and physical examination than in the sophisticated laboratory. Specialties have clearly defined fields of knowledge and action, have well established training programs and are culturally accepted, not so general medicine. In Chile, a significant number of trained general practitioners has not been attained, in spite of the existence of training programs since more than 20 years. Outpatient care (primary care in the language of health planners) may be undertaken by general practitioners but also, and perhaps with better efficiency, by general internists and pediatricians. The use of ones or others will depend on the geographic location (urban, suburban or rural), on the available physicians and the communication facilities with better developed medical centers. Within this line of thinking, the Faculty of Medicine of the University of Chile is studying a reform of medical curriculum, rotating internship and residency programs.