Abstract

The conceptual framework presented in this paper argues that basic nature of general medicine are in the “Interstices”: spaces between, rather than within, the familiar boundaries of accepted biological or psychological or social structures, such as “doctor”, “patient”, “family”, “health system”, “symptoms “,” beliefs “,” time”, “place”, etc. “Interstice” here is understood both in the topographical, bio-psycho-social, and metaphoric senses of the term. It refers to a space of the living of people in societies; to the spaces of inclusion and exclusion of people from the production process and relationship; and it refers to the sharp boundaries of the conventional structures. The Interstices are concrete “event spaces”. What exactly happens in the empty interstices of living organisms has not yet been investigated. These interstitial structures have a fundamental bio psychosocial importance and are recognized as the real basis for interdisciplinary research in medicine. The development of general medicine demands new ways of thinking about connections between different elements, and needs also new technologies to work with these connections. These spaces between boundaries are the appropriate places for potentialities to arise, to be creative, to produce novelties, to make bold thoughts. But, these interstices in which the academic discipline of general medicine live and develops are still very narrow. The biomedical and quantitative approaches are like two aircraft carriers that approach and barely leave a narrow gap between one and the other; however, in these gaps, in these clearings, is where general medicine lives, and from where it proposes an affirming, reflective, and transfiguring character of health care.

Keywords: General practitioner; Family medicine; Transitional spaces; Complexity; Theoretical models; Metaphors; Analogies; Virtual worlds; Technologies