Keywords: Healthcare system changes, generational knowledge, medical education

Keynote:

Health systems across Europe are under strain: aging population, rising multimorbidity, workforce shortages, and escalating fragmentation driven by increasing subspecialisation. In this environment, General Practitioners are often described as a gatekeeper. Sometimes the role of GP is diminished as mere referral coordinator.
I argue something more fundamental: General Practitioners are the clinical, ethical, and structural center of the health care system.
Family Medicine is the only discipline designed to manage undifferentiated problems, long-term problems and contextualized decision-making. While hospital medicine focuses on episodes of care, specialists focus on specific organs or disease, the GP is the key specialist for people over time. Continuity of care-one of the defining attributes of Family Medicine - is consistently associated with reduced mortality, fewer hospitalizations, and improved patient satisfaction. If quality is measured not only by technical precision but by coherence, safety, and sustainability, then primary care is not peripheral- it is foundational.
However, many systems are not structured around this reality. Administrative overload, digital inefficiencies, lack of funding and fragmented care pathways erode General Practitioners function. Young doctors entering Family Medicine often encounter isolation instead of mentorship, workload instead of leadership development, and resilience training instead of structural reform.
In this keynote, I will explore three interconnected themes:
First, quality as integration of complexity. The GP is uniquely positioned to balance competing guidelines, manage polypharmacy, and prioritize patient-defined outcomes. Investment in continuity and rational care are is an investment in measurable quality.
Second, mentorship as professional infrastructure. Early-career GPs must be supported not only clinically, but as system thinkers and future leaders. Mentorship should not be incidental; it should be embedded into the architecture of primary care.
Third, physician well-being as a structural quality indicator. Burnout in Family Medicine is not a failure of individual resilience; it reflects misalignment between responsibility and resources. If the GP is central to system stability, then protecting GP well-being becomes a patient safety priority.
Re-centering health care around strong primary care is not a fantasy- it is a strategic necessity. When health systems are designed around diseases, care fragments. When they are designed around institutions, costs escalate. When they are designed around enduring GP- patient relationships, care becomes rational and sustainable.
The future of Family Medicine depends on whether we are willing to move from rhetoric about its importance to structural commitment. As an early-career GP, I believe our generation must not only inherit the discipline- we must help redesign the system around it.