This Occasional Paper looks at current models of knowledge use in general practice. It contains a critical review of the literature, and draws on the author's empirical research and reflections from clinical practice. The paper critiques the model of Evidence-Based Medicine (EBM) and its implementation within health policy as Scientific Bureaucratic Medicine (SBM) - the latter defining best evidence in terms of an emphasis on scientific knowledge rather than clinical experience.

The author questions SBM's application to general practice given the complex and uncertain nature of much of the illness treated. She argues, instead, that the Interpretive Medicine (IM) model is better suited to the discipline of general practice. IM is the critical and thoughtful use of appropriate knowledge in the shared exploration and interpretation of illness experience.

As well as discussing IM, the paper also contains sections on:
* the nature of general practice
* current models of knowledge and practice
* consultation models
* defining the 'self' in personal care
* supporting creative capacity as a defining aspect of general practice
* judging quality of practice.

Although external quality standards are unavoidable, the author suggests that they are not adequate to support best practice in primary care. General practice needs to be understood as an intellectual discipline, defined by its interpretive skills. It should be defined not by the body of knowledge it uses, but by the way it uses knowledge.

The author's framework for evaluating the quality of knowledge in primary care, and her research priorities for developing the IM model, preserve core elements of the discipline of general practice, promoting and preserving it. In the era of EBM and great changes to general practice, Interpretive Medicine is sure to be become an influential paper.