Research to improve people's health


Josep Basora: “Jordi Gol i Gurina was a transformative person”

The director of the IDIAPJGol speaks in this interview about Jordi Gol i Gurina, the “people’s doctor”, whose birth centenary is commemorated this year. Basora emphasizes that the Institute preserves its legacy and represents the values that he always defended.

Josep Basora

Primary Care would not be the same without Jordi Gol i Gurina. This doctor and humanist laid the foundations for what is today the first level of care and for what is currently the general practitioner, the professional who knows the person and their environment and who takes into account all factors –physical, mental, and social– that influence their health, understood globally. His name survives in the leading research center in Primary Care, the IDIAPJGol. The director of the Institute, Josep Basora, believes that this year, in which the centenary of the birth of Gol i Gurina is celebrated, is a good opportunity to vindicate his figure and the essential role that the first level of care has, as well as to make known the centre that bears his name and keeps his values alive. Basora highlights the “rebellion” that Jordi Gol i Gurina exercised from the institutions, by advocating for social progress and equity, which “is a reflection of what the general practitioner is now, who, by definition, is a rebel.”

Why has it been decided to declare 2024 as the Jordi Gol i Gurina Year?

In fact, it is an initiative that comes from the Barcelona Professional College of Physicians, which dedicates it each year to an illustrious doctor who has modified clinical guidelines or who has developed innovative practices for the profession. In this sense, it has been decided to dedicate this year to Jordi Gol i Gurina, because it’s the centenary of his birth. This initiative has also been adopted by the Department of Health and the Generalitat of Catalonia. I am honoured that they have proposed me to be this Year's Commissioner, due to my experience as a family doctor and as the director of the IDIAPJGol. I think that this celebration is an opportunity, not only to make the figure of Jordi Gol i Gurina known, but also for the professionals, the administration, and the society in general to get to know our institute.

What contributions has Dr. Jordi Gol i Gurina made to medicine?

Jordi Gol i Gurina will always be remembered for the definition of health that he promoted at the Congress of Doctors and Biologists in 1976, which he understood as an aspect that goes beyond the absence of disease, linked to well-being, and joy of life. In addition, Gol i Gurina made other notable contributions. He was a very prolific person in the field of ethics from his basic Christian position. From that perspective, in the 1980s he defended the right to abortion for therapeutic purposes in its broadest sense, which also included psychological reasons. This position clashed with the official trend of the Church at that time and made him popular in the media. He was a person with great communication skills, who received the nickname “doctor of people.”

Besides, Jordi Gol i Gurina defended the recovery of the spirit represented by the figure of the general practitioner, the person who knows the patient, the family and the environment in which he lives, and was critical of the depersonalization of medicine. He worked a lot on social and healthcare integration in clinical practice, knowing more about the patient and addressing their needs in a multidisciplinary way. In addition, he worked on the contents that the medical records should have. At that time, there were many professionals who worked with medical records, but others did not, and its format was not standardized. He defined the contents that it should have, and he did so with an informative campaign in the media.

Furthermore, he always said that healthcare practice should be based on evidence. He picked up on the currents that were emerging in Canada, the United Kingdom, the United States, and the Nordic countries, where Primary Care and the figure of the general practitioner were being developed. After his death, when the creation of the Medical Residence for Family Medicine began to be considered, many of his points of view on what this specialty should be were collected. The first family doctors who went to work in the community were internists, and one of them was Jordi Gol i Gurina.

How does his legacy live on in the practice of family medicine today?

The clinical record as we know it today includes the foundations laid by Jordi Gol i Gurina. It is evident that complementary tests, coding requirements and many other things have later been integrated in the clinical history, but he laid the foundations for what the clinical history should be as we understand it now, not only with respect to the contents, but also to the fact that it is considered a patient’s right.

On the other hand, I believe that the transformative spirit and the rebellion of Dr. Jordi Gol i Gurina, although he exercised them inside the institutions in which he worked, are a modern reflection of what the general practitioner is now, who, by definition, is a rebel. Family medicine and Primary Care are linked to social progress and equity, which explains why the general practitioner and Primary Care often do not quite fit into the system.

Jordi Gol i Gurina did not dedicate himself directly to research, at least as we currently understand it. Why, then, is a research centre like IDIAPJGol named after him?

Jordi Gol i Gurina is one of the leaders of the profession. He was a person who stood out publicly, whose prestige went beyond Primary Care –even The Catalan Academy of Medical Sciences has an award named after him– and who was a humanist. Research in Primary Care has two differentiating features. The first is that the results directly impact the patient and the second is that it contains psychosocial aspects and humanistic aspects that condition the research. Jordi Gol i Gurina introduced these practices in Primary Care. He was a person who worked at the first level of care, who was recognized by other specialties and other health professions. The IDIAPJGol is the legacy of his thought. He believed in scientific evidence, and he believed in best practices, and the fundamental mission of IDIAP is to research best practices in Primary Care and create evidence. He himself and his family were linked to the board of the Institute. There have been links with his family, which we will now try to strengthen on the occasion of the celebration of his centenary.

The name of Jordi Gol i Gurina is linked to IDIAP, an institution that has made it possible for many Primary Care professionals to do research. Many people identify with us, with our orientation towards research that attempts to change clinical practice and that adapts to the needs of Primary Care. The values of IDIAPJGol are the values of the Primary Care. Here we have a community of 4,500 people who do research. The great challenge we have is to make the IDIAP better known, and the celebration of this Jordi Gol i Gurina Year is an opportunity to achieve this. We must know how to take advantage of it.

Is the figure of Jordi Gol i Gurina sufficiently known within the profession?

I think not, and Primary Care lacks references that project an image like his. The Avedis Donabedian Foundation refers to these references in the healthcare field as homenots, big men, taking this term from Josep Pla. We can define Jordi Gol i Gurina as a homenot, because he was a person who tried to influence the world to change it. Therefore, he continues to be a hallmark of Primary Care and the Health System and recovering him is recovering references and recovering his identity.

What do we have prepared for this Jordi Gol i Gurina Year?

We are honoured that the Department of Health has entrusted us with the main activity of the Jordi Gol i Gurina Year celebrations, which will be on May 16, at the IDIAPJGol Biannual Conference. In fact, the inaugural conference will be given by a representative of ours, who is Dr. Bonaventura Bolíbar and Dr. Pilar Astier, a member of our External Scientific Committee, and part of the governing board of WONKA, which is the international general practitioners’ association, and delegate to the World Health Organization for Primary Care. They will talk about how Jordi Gol i Gurina’s principles –people’s doctor, comprehensive health, multidisciplinary health centres...– are currently applied and how they are projected in the future of Primary Care. It will be a discussion that will be much more academic than vindictive, but IDIAPJGol is an academy, it is a research institution.

There are other events too. The opening ceremony will take place at the Barcelona College of Physicians on May 2, in which the figure of Jordi Gol i Gurina will be discussed in all its dimensions, its hospital dimension, its dimension as a modern Christian, its ethical dimension and its role in Primary Care. I have the privilege of being the moderator of the event. This is a good starting signal. There will also be another event, organized jointly by the Catalan Institute of Health and the Catalan Society of Family and Community Medicine, which will be on October 3, an intergenerational dialogue, between Dr. Carles Blai, who is a great disseminator who is interviewing one hundred Primary Care doctors, and a family medicine resident, who will probably be the granddaughter of Dr. Jordi Gol i Gurina. Then we have the closing ceremony, which will be very nice, at the Department of Health, in which a book by Jordi Gol i Gurina will be presented and in which a commission of experts will also discuss their definition of health, considering the current times. The moderator of this event would be Dr. Carmen Cabezas, director of the Public Health Agency of Catalonia and who had been a prominent researcher at IDIAPJGol.