General Medicine in the Time of Coronavirus Disease 2019 (Covid-19) and Beyond: Is it Falling Apart, Changing or Reinforcing? The Theory of the Braid Group

Abstract

Coronavirus disease 2019 (COVID-19) has produced a dramatic change in the practice of general medicine (GM). Many of the aspects that were taken for granted in it have been profoundly altered. The most spectacular change has to do with telecare/telehealth: Remote consultations without the physical presence of the patient, which account for 80% of the total and which in all probability will be permanent. This situation affects the basic principles or tools of GM, especially the doctor-patient relationship that seems to disappear and consequently to crumble the practice. However, this article proposes another opposite view: The basic principles of GM doctor-patient relationship, continuity of care, contextualization and comprehensiveness are interwoven. In this way, even accepting the weakening of the doctorpatient relationship, the changes in the practice based on telecare may mean a reinforcement of the continuity of care, contextualization and comprehensiveness. What makes GM so effective and efficient is not the doctor-patient relationship in isolation, but the braiding of its set of basic principles/tools. Consequently, the braided group structure achieves a complex pattern that is greatly reinforced, achieving more strength, toughness and resistance to fatigue, suppressing cracks and supporting each other. Changes in the COVID-19 and post-COVID-19 era will greatly strengthen GM.