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Strengthening Advanced Medical Generalism


Professor Joanne Reeve

Professor Joanne Reeve

Professor of Primary Care Research



Why this research is needed

The NHS needs more generalist healthcare. Growing proportions of patients present with complex whole person healthcare problems such as multimorbidity, treatment burden, problematic polypharmacy, and persistent physical symptoms. Here, the use of specialist medicine alone adds to the burden of overmedicalisation and intervention experienced by patients, professionals and health systems alike. Healthcare needs to work differently.

But health systems continue to misunderstand what the generalist role is. Medical generalism is not simply the coordinated delivery of lots of different types of specialist medicine. It is a distinct form of medical practice able to critically generate, use and appraise new whole-person understanding of illness-in-context.

Advanced Generalist Medicine (AGM) is the complex skill set used by advanced practitioners to flexibly manage the uncertain and complex reality of everyday front-line practice. It is the applied medical practice of a skill set (knowledge work) that is highly prized in many other professions, but is not adequately recognised and supported within modern healthcare practice.

Advanced Generalist Medicine relies not simply on clinicians who know a little bit about lots of different diseases; but on having practitioners trained and skilled to critically and creatively adapt and apply what they know to address a complex problem-in-context. This is the knowledge work of advanced generalist medicine and is the focus for our ground-breaking work at the Academy of Primary Care.

What we are doing

Professor Reeve is an international leading authority on the practice of advanced medical generalism.

In her 20 years of studying medical generalism, I have seen it being designed out of medical practice, teaching, and healthcare policy. I have witnessed and researched the negative impact of these changes on patients, professionals, and healthcare delivery.

So, in response, I now lead and help deliver work to restore and reclaim the wisdom of general and generalist practice through our work within APC and at WiseGP. At the heart of that work is a goal to recognise and restore the distinct knowledge work of general and generalist practice.

Previous research has revealed four barriers to advanced generalist practice. People aren’t sure what it is; and how it fits in their daily practice. They lack skills and confidence in doing the work, and don’t get the support they need to maintain best practice

In her new book, she tackles each of these barriers using evidence from research generated over years to describe:

  • Why AGM matters – what it is and how to do it
  • How it fits within modern everyday practice
  • The skills and resources needed to do it well
  • How we can judge have done it well

The book provides a blueprint for a refresh of professional training, practice design and policy.

What we found so far

Professor Reeve's book 'Medical Generalism, Now!' outlines a blue print for restoring advanced generalist medicine. Now informing new research and scholarship developments with NHS, University and public partners across the UK.

Work resonates with and supported by an international audience: The book recognises the international challenges and opportunities inherent in this work – with a discussion chapter with international colleagues on the relevance and implications for colleagues in Australia, America, Japan and Europe.

It provides basis for implementation research and practice we are now designing and delivering, including through the WiseGP programme.

Contact us

We welcome enquiries about our research, or if you are interested in collaborating, visiting or postgraduate research opportunities with us.

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