The 12th WONCA Europe takes place in Florence, Italy (Firenze, Italia) from the 27th to the 30th August 2006. It has taken as a theme ‘Towards a Medical Renaissance – Bridging the Gap Between Biology and the Humanities’. This will be addressed under six sub-themes: biology and humanities; risk and safety; family practice research; caring for the world; quality of family medicine; and education. The theme is a highly appropriate one for WONCA, especially in Europe. Medicine as whole is in need of a rebirth to reassert the appropriate balance between the scientific and humanistic aspects of the healing endeavour and the emergence, re-emergence or resurgence of general practice/family medicine in many healthcare systems is at the vanguard of this movement. General practitioners in their daily work bridge the gap between what can be achieved by medical technology and what can be achieved by simply being with people, sharing their stories and empathising with their suffering.
The renaissance of 15th century Europe which, arguably, had Florence as its epicentre, is an appropriate paradigm from which to consider the development of medicine in the current era. Medicine was then, as now, a key enterprise. However, until the renaissance, it had been in something of a rut with set ways of thinking and doing things. We may think of modern medicine as constantly advancing by way of dramatic technological leaps but, in reality, we may be reaching the limits of scientific medicine. Recent medical ‘breakthroughs’ such as trastuzumab (Herceptin) for breast cancer and drug eluting stents for coronary heart disease, while dramatically effective for some individuals, are, in truth, refinements of existing technologies rather than truly revolutionary. The decoding of the human genome was hyped as something that was going to give birth to a whole new era of medicine but it has, so far, disappointed. Just as a different approach and the application of new subjects of study, such as anatomy, drove medical advance in the Renaissance it may well be that the study of new disciplines such as anthropology and linguistics may drive the renaissance of medicine in our time. Certainly, there are enormous problems in the delivery of healthcare facing our generation that will not be answered by the application of molecular biology, regardless of any future advances in that field. There are, for example, the issues of ill health and death that are the consequences of poverty and conflict in many parts of the world. The potential for doctors, and family doctors in particular, to make a relevant contribution to their solution will be highlighted in the ‘Caring for the World’ sub-theme. Similarly, all technological advances come with their downsides and finding the correct balance between risks and benefits presents it own challenges to be addressed in the ‘Risk and Safety’ sub-theme. Once technologies are developed their optimal application must also be the subject of clinical research. Most clinical research currently goes on in hospital settings. There is a great need for more clinical research to investigate prevention, diagnosis and treatment in the setting where most of it occurs i.e. general practice.
The Renaissance began with a revival of interest in the past and, in particular, in the classical eras of Greece and Rome but this spurred that generation on to new thoughts, new ideas, and new technologies. Medicine too needs to look back at what was good from former times. The emphasis on care rather than cure, the reliance on clinical and communication skills rather than on laboratory or radiological investigations to find the cause of patients’ symptoms, and the recognition of the need sometimes to be with people in their suffering rather than to be always doing things to them all may seem like something from a bygone era. It is timely to re-examine the values underpinning our medical practice and where medicine is going and where it ought to go. I can think of no better place to contemplate all this than in Florence where one is surrounded by the most inspiring art and communing with wonderfully cordial Italians. Colin P. Bradley Chief Editor