2021
DOI: 10.1111/jep.13624
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The Craft of Generalism clinical skills and attitudes for whole person care

Abstract: Rationale, aims and objectives Generalists manage a broad range of biomedical and biographical knowledge as part of each clinical encounter, often in multiple encounters over time. The sophistication of this broad integrative work is often misunderstood by those schooled in reductionist or constructivist approaches to evidence. There is a need to describe the practical and philosophically robust ways that understanding about the whole person is formed. In this paper we describe first principles of generalist a… Show more

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Cited by 11 publications
(29 citation statements)
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“…One plausible explanation for the high levels of jobrelated stress found in this study, is the well-documented increase in responsibilities and working hours among Norwegian GPs in recent years [22,28,32]. However, in combination with high workload, characteristics of general practice as a "frontline" medical discipline may also be important [33]. When assessing patients' problems, experienced GPs may discern contributing contextual causal factors that inexperienced GPs might not recognise or focus on.…”
Section: Discussionmentioning
confidence: 79%
“…One plausible explanation for the high levels of jobrelated stress found in this study, is the well-documented increase in responsibilities and working hours among Norwegian GPs in recent years [22,28,32]. However, in combination with high workload, characteristics of general practice as a "frontline" medical discipline may also be important [33]. When assessing patients' problems, experienced GPs may discern contributing contextual causal factors that inexperienced GPs might not recognise or focus on.…”
Section: Discussionmentioning
confidence: 79%
“…Support for primary care must align with how it functions, and yet how primary care works is widely misunderstood 63,64 . Too often, it is conceptualized, measured, and incentivized based on pieces of the whole—disease care or “management,” preventive service delivery, serving as a referral mechanism, etc 14 .…”
Section: Interacting Mechanisms: How Primary Care Work To Advance Per...mentioning
confidence: 99%
“…3,61,62 Support for primary care must align with how it functions, and yet how primary care works is widely misunderstood. 63,64 Too often, it is conceptualized, measured, and incentivized based on pieces of the whole-disease care or "management," preventive service delivery, serving as a referral mechanism, etc. 14 Misunderstanding primary care has led to often well-intentioned but damaging efforts to improve these parts, absent an understanding of their interdependencies and how they articulate as a whole.…”
Section: Interacting Mechanisms: How Primary Care Work To Advance Per...mentioning
confidence: 99%
“…The six papers [2][3][4][5][6][7] referred to in this philosophy theme edition of the journal describe complex problems, however, most do so only implicitly (Table 2). If the aim of philosophical discourse is to clarify and enlighten, would it not be more useful and powerful to do so explicitly?…”
Section: Medicine's Task-dissolving Wicked Problemsmentioning
confidence: 99%
“…SARS-CoV-2 as a 'whole-of-system' perturbation of complex multi-layered dynamic hierarchies The craft of generalism 4 The Person as a whole • Philosophy of health o Across the ages, EXCEPT for the Greek and Cartesian dualist interruptions, human beings have been understood as 100% material (or bodily) AND 100% dynamic, social, relational, experiential and meaningmaking organisms situated in culture and environment (and some would add 100% spiritual and transcendent). o Pellegrino: 'A healing decision is one that will make the patient whole again' need to embrace our patients as people we need to understand in their suffering.…”
Section: Medicine's Task-dissolving Wicked Problemsmentioning
confidence: 99%