David O’Brien is a GP partner and trainer and academic GP at the University of Leeds
General Practice is under ever increasing pressure – a frequently heard and rarely disputed statement. While we are only too aware of what that increasing pressure means -and feels like -there is uncertainty of what it is we actually do. What is a ‘General Practitioner’? The ‘practitioner’ component is easy enough to comprehend, given the terms ubiquity amongst many professions, but the ‘General’ part?
This is trickier…
Pushing through the description ‘Jack of all trades,’ Griffiths illustrates the importance of a Generalist in his effective and emotive TED talk but what is ‘Generalism’?1
Descriptions in medical literature range from the evocative ’Mystery of General Practice ‘described by Dr Iona Heath in 19952 to Norman’s recently published and imaginative Platypus analogy3 but while thematic these don’t necessarily help clarify what a GP’s job is.
How can we defend, promote or indeed model a concept which can feel nebulous. I propose that the reason there is so much difficulty behind finding a working definition for ‘Generalism’ is that Generalism is not a word but rather an acronym – and we know how Medicine loves an acronym.
So what does Generalism stand for? In my opinion it could stand for:
Generating Diagnoses – building diagnoses from undifferentiated data
Engineering solutions – giving workable tailored plans to problems
Narrowing health inequalities – promoting health to all
Experiential learning – constantly practising and evolving
Radical thinking – applying mental agility in the face of complexity
Allocating resources –performing the role of both gatekeeper and signposter
Leading – a visible presence in directing teams, patients, change
Investing in the future – laying down foundations for patients on an individual and larger scale
Skill development – acquiring and adapting techniques
Making relationships -forging connections between patients, colleagues, communities
Making explicit the roles and activity of the General Practitioner has many benefits. It enables others to recognise, value and utilise our work. It helps solidify vague notions into understandable and teachable components. It also informs the GP after a busy session when everything is a blur, what it is, they have been doing.
References
- Griffiths, J. Choosing to be a Jack of All Trades – drjongriffiths.wordpress.com https://drjongriffiths.wordpress.com/2016/11/25/tedx-nantwich-choosing-to-be-a-jack-of-all-trades/ Accessed April 14, 2024
- Heath, I. 1995. The mystery of general practice. Nuffield Trust. https://www.nuffieldtrust.org.uk/sites/default/files/2017-01/the-mystery-of-general-practice-web-final.pdf Accessed April 14, 2024
- Norman, A.H. Embracing general practice’s inner platypus– BJGP Life
https://bjgplife.com/embracing-general-practices-inner-platypus/ Accessed April 10, 2024
Featured photo by Brett Jordan on Unsplash
