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Advancing Generalist Expertise

We need person centred primary care, now more than ever1.

In the Advancing Generalist Expertise SIG, we understand person-centred care as the delivery of personalised health care. Personalised care refers to individually tailored, integrated health care2.. Care that recognises health as a resource that people need and use to live their daily lives, not an end in itself3.

We differentiate between personalised and personal care4.

Personal care recognises illness as a biopsychosocial experience occurring in a wider social context. Models of care need integrated teams addressing multiple elements, underpinned by a commitment to empathic care.

Personalised care refers to the intellectual task of interpreting the illness experience of this individual: offering an individually tailored and integrated explanation of illness, supporting the co-construction of a management plan5.

Delivering personalised medical care is the expertise of the generalist physician. Family Physicians and General Practitioners are the largest group of generalist physicians in western health systems. There are international calls to rebalance health systems through strengthening generalist care. Yet we also see ongoing uncertainty about how to achieve that goal in practice.

We are an international group of clinicians and scholars, working to advance generalist expertise. We seek to describe and so raise understanding of personalised care and generalist practice through collaborative scholarship. We work to design, and so deliver and evaluate generalist models of care. In order to enhance personalised, person centred care at the heart of strong and effective primary healthcare systems.

Past work includes a paper describing the application of generalist principles to addressing multimorbidity6. We are currently working on projects including an international assessment of generalist teaching in medical curricula, understanding public perceptions of generalist expertise and developing shared international understanding of generalism.

  1. The World Health Report 2008 – primary health care (Now More Than Ever). www.who.int/whr/2008/en/
  2. Tinetti E, Fried T. The end of the disease era. Am J Med 2004; 116: 179-185
  3. Williamson DA, Carr J. Health as a resource for living: advancing the conceptualisation. Critical Public Health 2009; 19(1): 107-22.4.     
  4. Reeve J, Lynch T, Lloyd-Williams M, Payne S.  2012. From personal challenge to technical fix: the risks of depersonalised care. Health and Social Care in the Community; 20(2): 145-154.
  5. Reeve J. 2010. Interpretive Medicine: supporting generalism in a changing primary care world. London: Royal College of General Practitioners Occasional Paper Series, 88.
  6. Reeve J, Blakeman T, Freeman GK, Green LA, James P, Lucassen  P, Martin CM, Sturmberg JP, van Weel  C. 2013. Generalist solutions to complex problems: generating practice-based evidence - the example of managing multi-morbidity. BMC Family Practice; 14:112. DOI: 10.1186/1471-2296-14-112. Highly Accessed

To find out more, do get in touch. You can email Joanne at j.reeve.1@warwick.ac.uk.