A filosofia da Medicina de Família e Comunidade segundo Ian McWhinney e Roger Neighbour

Introduction: This article revisits the philosophical assumptions of Family and Community Medicine (FCM) from Ian McWhinney’s and Roger Neighbour’s writings. Objective: To strengthen the discussion on the theoretical foundations of FCM both in the academy and in residency programmes in FCM. Methods: This is a reflexive essay that compares and analyses two of the main books on FCM: the classic “Textbook of Family Medicine” by Ian McWhinney and “The inner physician: why and how to practise ‘Big Picture Medicine’” by Roger Neighbour. Results and Discussion: Ian McWhinney and Roger Neighbour apply the epistemology of Thomas Kuhn to propose a different paradigm to medicine. In this process, the authors developed distinct but complementary proposals that we decided to categorise into: (a) McWhinney’s organismic paradigm and Neighbour’s quantum paradigm; (b) a distinction between general practitioner and focal specialist; and (c) doctor-patient relationship and with itself. Conclusion: To navigate the uncertainties of general practice, it is necessary to nurture and reflect on the essence of FCM, both in undergraduate courses and in residency programmes, to train professionals sensitive to the human condition.