The structure of ICPC is biaxial, with 17 chapters on the horizontal axis and 7
components on the vertical (Figure 4.1). In the chapters, body systems take precedence
over etiology. The patient’s reason for encounter is the patient’s given reason
as interpreted by the doctor. Most are symptoms and complaints, which are
recorded under the appropriate chapter heading. Each chapter has rubrics for fear
or disability associated with a symptom. If the RFE is a preventive procedure,
prescription, test result, or medical certifi cate, this is recorded under the appropriate
chapter heading under components 2, 3, 4, or 5. The process of care and the
diagnosis are encoded and recorded under the appropriate chapter heading.
With this structure, ICPC can provide a profi le of family practice that represents
its complexity (see Figure 4.1).
As in all classifi cation systems, the accuracy of ICPC depends on the skill
of the recording physician. The RFE is not necessarily the same as the presenting
complaint, and underlying reasons may not emerge at the fi rst encounter.
Much depends on the physician’s knowledge of the patient and consulting
skills. Consistency in assigning diagnostic labels is difficult to attain in the many
illnesses that cannot be differentiated to more than low levels of abstraction. All