Background. General practice is the focal point of primary care. There
are national differences in the structure and organization of practic
e, the relationship with secondary care is being redefined, and in som
e countries major changes are taking place. Aim. To describe and exami
ne differences in the service profiles of general practitioners (GPs)
in European countries. Method. Standardized questionnaires in the nati
onal languages were sent to samples of GPs in 1993. Four areas of serv
ice provision were measured: the GP's position in the first contact wi
th selected health problems, the involvement in minor surgery and the
application of medical procedures, disease management and preventive c
are. The importance of the gatekeeping role, remuneration system, and
geographical region in Europe was examined by comparing scores in appr
opriate national groupings. Results. Data were received from 7233 GPs
in 30 countries. Most national samples were random and the average res
ponse rate was 47%. In countries where GPs have a gatekeeping role, th
ey had a relatively stronger position as doctors of first contact. In
those countries where GPs were usually self-employed, they had a stron
ger role in disease management and screening for blood cholesterol. In
the examination of the three structural elements of health care, the
most striking differences were evident in the comparison between easte
rn and western Europe. GPs throughout Europe had a comparatively small
role in organized health education. Conclusion. The position of GPs i
s weak in eastern Europe and some Mediterranean countries, where servi
ce profiles have a limited range. General practice was more comprehens
ive where the doctors had a gatekeeping role.