Medical Generalism, Now! is a unique and timely consideration of generalist medical practice. With a focus on the knowledge work of clinical practice and by taking a whole healthcare system view, the book responds to a recognized need to strengthen generalist practice within modern healthcare delivery in both primary and secondary care settings.
Through a series of creative provocations directed to consulting clinicians and their trainers/educators, service leaders and managers, and policy makers, readers are encouraged to challenge the orthodox view that generalism is an outdated 'jack of all trades sub-set of clinical medicine delivering the simpler aspects of medicine, with more complex issues requiring onward specialist referral. Case studies are used throughout to illustrate the challenges to be faced, accompanied by a description of the principles of generalist knowledge work needed to tackle the scenarios described and discussing the implications for practice and service redesign.
Essential reading for clinicians, managers and policy makers across all healthcare settings, the book concludes with a call to action, synthesizing the learning from each chapter to define and describe delivery of the key changes needed.
The book is a unique and timely consideration of generalist medical practice. With a focus on the knowledge work of clinical practice and by taking a whole healthcare system view, the book responds to a recognized need to strengthen generalist practice within modern healthcare delivery in both primary and secondary care settings.
Recenzijas
"But for someone who wants to transform their general practice into a wise place where generalist care is possible, or instil fire in their belly to challenge a healthcare system that seems designed to pervert this kind of care, Reeves new book is worth a look."
- Professor Trisha Greenhalgh, BJGP Open
Preface
About the Author
Additional Contributors
Chapter 1: Principles of Whole Person Medicine
1.1 The purpose of Whole Person medicine. 1.2 The focus for whole person
care: the Creative Self. 1.3 The goal of healthcare: enhancing health for
daily living. 1.4 The work of healthcare: creating understanding in context.
1.5 The context of WP healthcare: complex interventions. 1.6 Summary.
Chapter
2. Wise Foundations: the knowledge work of practice
2.1 The knowledge work of clinical practice. 2.2 The knowledge work of
specialist medicine. 2.3 The alternative knowledge work of generalist
practice. 2.4 Barriers to generalism in action. 2.5 Generalism in action: the
4Es of best practice. 2.6 Advanced generalist practice: Emperors new
clothes?2.7 Knowledge work: the missing piece in person-centred healthcare
redesign.
Chapter 3: Wise People delivering the knowledge work of advanced generalist
practice
3.1 The Flipped Consultation. 3.2 Goldilocks Medicine. 3.3 Heaths Generalist
Gatekeeper or Guru. 3.4 Summary.
Chapter 4: Wise Places practices supporting advanced generalist knowledge
work
4.1 Enabling the work of advanced generalist practice: redesigning the
generalist practice. 4.2 BOUNCEBACK: enabling knowledge work in context. 4.3
COMPLEX NEEDS: Enabling knowledge work in context for multimorbidity. 4.4
PACT: creating places for tailored care knowledge work. 4.5 Conclusions:
Creating Wise Places.
Chapter 5: Wise Systems the advanced generalist healthcare system
5.1 Setting the scene New Public Management. 5.2 CATALYST - knowledge work
drivers for system change, a workforce example. 5.3 TAILOR - knowledge work
drivers for system change, a workplace example. 5.4 UNITED GENERALISM a
policy example. 5.5 Implications for Medical Generalism, now.
Chapter 6: Medical Generalism, Now
6.1 Starting in Primary Care. 6.2 Wise Policy. 6.3 Wise Practice. 6.4 Wise
People. 6.5 Medical Generalism Now.
Chapter 7: Medical Generalism, everywhere?
Index.
Professor Joanne Reeve is an academic GP committed to excellence in academic primary care at the heart of the design and delivery of quality primary care. Primary care is the bed rock of the NHS, and is underpinned by a discipline of academic primary care which delivers the workforce, research evidence and strategic vision for practice and policy. Joanne graduated from Liverpool Medical School in 1997, and started out planning a career in public health medicine. A Masters in Public Health rekindled her interests in the professional, clinical and academic challenges of developing person-centred healthcare. She returned to General Practice and successfully applied for doctoral funding from the NCCRCD (the precursor to NIHR) to look at person-centred management of distress in terminal illness. Following her PhD, she worked in Manchester, Liverpool and Warwick developing a portfolio of work on Primary Care redesign based on the principles of medical generalism (whole person medical care). Her work has been supported by fellowships from the NIHR (including a Clinical Lecturership at Manchester, and a Clinician Scientist Award at Liverpool). Joanne joined Hull York Medical School in 2017 to establish the Academy of Primary Care - championing innovative scholarship driving excellence in primary care provision.
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