Generalism in Clinical Practice and Education

Edited by Sophie Park and Kay Leedham-Green and foreword by John Launer

ISBN: 9781800085428

Publication: July 25, 2024

Open Access PDF £0.00 Hardback £60.00 Paperback £40.00

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Generalism is a key approach to healthcare organisation and delivery that enables person-centred, dynamic and cost-effective patient care. With its emphasis on adaptability, generalism requires expansive, nurturing and personalised approaches to clinical education in which a generalist attends to and explores patient priorities when problem-setting and co-creating management plans.

Generalism in Clinical Practice and Education outlines a generalist philosophy of practice which is brought to life through interleaved examples. Written by a range of international clinicians, patients and academics, this book does not prescribe one ‘right’ way to do generalism. Rather, it seeks to inspire readers’ future engagement with generalism in practice and learning through sharing underpinning concepts, values and principles. This ‘big picture’ attention to generalism across public health, social determinants of health and clinical care is at the heart of sustainable and efficient use of resources to prioritise those in need. The book explores four key principles which in practice aim to achieve creative, inclusive and agile approaches to clinical care. The goal is to support generalism in clinical practice and education, and to produce clinical practitioners and learners that enjoy, embrace and enhance future clinical care.

Praise for Generalism in Clinical Practice and Education

'As countries around the globe tackle meaningful reforms of their struggling health systems, a focus on the benefits of generalism in healthcare delivery is essential. This wonderful new book shares insights on how to strengthen generalism across all aspects of health care, to the benefit of individuals and communities (and health systems) everywhere.'
Professor Michael Kidd, University New South Wales and University of Oxford and Past President of WONCA (World Organisation of Family Doctors)

'The clinical generalist is in danger of becoming extinct. This book explains, from both theoretical and practical perspectives, why we should not let that happen.'
Professor Trisha Greenhalgh, University of Oxford

'This book extends the discourse about the importance of generalism in healthcare to a new depth and breadth. It is an extensive and scholarly application of the concept into practical action across the educational and healthcare system. Whether taking a formal academic approach to curriculum and outcomes of training, or flipping to the perspective of the community and its empowerment, this text has something new to offer. Its contents add impact to a crucial set of choices, and will help its application at many levels. Well done to all involved.'
Professor Amanda Howe, University of East Anglia; Past President of the Royal College of General Practice; Past President WONCA (World Organisation of Family Doctors)

'This wonderful book is a veritable festival of generalism and education. The passion, principles and expertise of the authors radiates out from the pages. It is a perfect stimulus to enthuse and sustain a new generation of generalists, educators and scholars (ideally all three, together).'
Karen Mattick, University of Exeter and President of the Association for the Study of Medical Education (ASME), as well as Deputy Editor for the Journal of Medical Education

'An authoritative and comprehensive guide to Generalism for clinicians and educators. This book will help the movement of Generalism into everyday clinical practice. The emphasis on Generalism being for all clinicians in all disciplines is well made throughout.'
Professor Steve Turner, Royal Aberdeen Children’s Hospital

'This book is a celebration of generalism in medicine, a vitally important concept that the medical profession loses at its peril. The advances in specialty medicine have been spectacular over the years, but I, for one continue to be proud to call myself a general physician with a specialty interest. Most of the people we see and support have more than one condition, and benefit hugely from a generalist approach. Congratulations to Sophie Park and colleagues for reminding us'.
Professor Dame Jane Dacre, General Physician and Rheumatologist and Past President of the Royal College of Physicians.

'To become a generalist doctor is to open yourself up to an endlessly fascinating and rewarding career. It's a privilege to get to know your patients whatever their problem, using medical science in the service of kindness, and understanding patients' social context. UK primary care manages 90% of NHS encounters with patients with only 9% of the funding – Generalism in Clinical Practice and Education shows that with just a little more funding, General Practice could transform the health of the nation.'
Gavin Francis, GP and author

Sophie Park is Professor of Primary Care and Clinical Education at the University of Oxford and a General Practitioner in Hertfordshire.

Kay Leedham-Green is a Senior Research Fellow in the Medical Education Research Unit at Imperial College London.

List of figures
List of tables
List of contributors
Foreword by John Launer
Acknowledgements
About this book

**Part I: Core concepts**

1 What is generalism and why is it important?
Sophie Park, Kay Leedham-Green and Tanya Cohen

2 Generalism across disciplines
Martina Kelly, Rupal Shah, Nicola Clarke and Jens Foell

3 Patient priorities and perspectives
Anya de Iongh and Fiona McKenzie

4 Researching generalism
Lindsey Pope, Helen Reid, Nigel Hart, Emily Owen and Sophie Park

5 Implementing generalist knowledge
Sophie Park, Claire Duddy and Kamal Mahtani

Part II: Educational approaches

6 Education for clinical generalism
Sophie Park, Kay Leedham Green and Ben Jackson

7 Generalism and assessment
Eleanor Hothersall and Eliot Rees

Part III: Systems approaches

8 Organisation and design of healthcare for generalism
Stewart Mercer, John Gillies and Clare MacRae

9 Collaborative and integrated working
Emily Owen, Charles Coombs and Sophie Park

10 Supporting generalism through health justice partnerships
Hazel Genn and Sophie Park

11 Generalist approaches to community health needs Jane Myat, Jane Riddiford, Sadie Lawes-Wickwar and Henry Aughterson

12 Making general practice and clinical education socially accountable
Sadie Lawes-Wickwar and Jane Hopkins

13 Sustainability, health and healthcare
Alice Clack, Frances Mortimer and Kay Leedham-Green

14 Generalist approaches to quality improvement
Rebecca Mackenzie and Nitisha Nahata

Part IV: Generalist interactions

15 Interactional knowledge
Graham Easton

16 Prescribing and de-prescribing: the generalist’s script
Deborah Swinglehurst and Nina Fudge

17 Embedding health and wellbeing into clinical practice and education
Jessica Xie, Kay Leedham-Green and Sara Thompson

18 Addressing multimorbidity through personalised care
Danielle Nimmons, Emma Hyde and Kay Leedham-Green

Index

“This book is a celebration of generalism in medicine, a vitally important concept that the medical profession loses at its peril. The advances in specialty medicine have been spectacular over the years, but I, for one continue to be proud to call myself a general physician with a specialty interest. Most of the people we see and support have more than one condition, and benefit hugely from a generalist approach. Congratulations to Sophie Park and colleagues for reminding us”.

Professor Dame Jane Dacre, General Physician and Rheumatologist and Past President of the Royal College of Physicians.