AoPC_1

AoPC_1

What we do

Academy of Generalist Medicine

Lead: Professor Joanne Reeve

Building capacity for generalist medicine is a priority recognised in the NHS Long Term Plan; whilst the 2020 Health Education England Future Doctor report declared that the "doctor of the future is a generalist".

Professor Reeve is internationally known for her research-led programme of work to describe, deliver and evaluate the clinical scholarship of expert generalist medicine for modern clinical practice. She has described the evolution of generalist expertise from a ‘jack of all trades’ model to a distinct expertise in clinical scholarship. At the Academy, we are applying this model to address key challenges in medical education and clinical practice, including our work to tackle problematic polypharmacy.

Projects

Tackling Problematic Polypharmacy: the TAILOR Medication Synthesis

Contact: Professor Joanne Reeve
Funding: NIHR HTA

Growing numbers of patients report feeling burdened by taking multiple medicines on a daily basis. Doctors and patients alike want to know how best to safely tailor medication plans to each individual.

This research uses advanced review methods to describe a new model of best practice for individual tailoring of medicines (generalist prescribing), and so provide medicine users (patients and clinicians) with the help they need to improve care.

Tackling Problematic Polypharmacy: Addressing Complex Needs

Contact: Professor Joanne Reeve

Our work brings together clinical and research scholarship to deliver prescribing-related quality improvement projects in the practice setting.

Our goal is to develop the practice-based evidence needed for modern health care.

Past projects featured in a 2013 RCGP report on managing multimorbidity, and in a 2019 RCP event on Avoiding Harm from Over-Prescribing.

Clinical Decision Making in the Ambulatory Care Setting

Contact: Professor Joanne Reeve
Funding: Oxford CLAHRC

Led by Dr Sara McKelvie (University of Oxford), this innovative work examines the Clinical Decision Making processes of doctors working in the acute ambulatory care setting.

Using observation methods, Sara is developing new insights into the daily work of clinicians in a complex and high-risk setting. Her findings will offer insights into how we train, support and possibly select clinicians to work in interface and primary care contexts. 

Curriculum Review

Contact: Dr James Bennet and Dr Puja Verma (Academy GP Portfolio Fellows)
Funding: Hull York Medical School

Recent publication of key documents from RCGP, SAPC  and Health Education England describe the core general practice and primary care concepts needed for modern medical school curricula.

In 2020, the Academy is leading a review of the Hull York Medical School curriculum against these standards. A documentary analysis of educational content has been completed, and we are now engaged in stakeholder interviews and focus groups to critically examine initial findings. A report and recommendations is planned for the end of 2020

Clinical Epistemology

Contact: Professor Joanne Reeve

Clinical scholarship is an essential component of modern clinical practice. The expertise of generalist medicine relies not on what a clinician knows, but how they use that knowledge to interpret, explain and manage illness.

The skills of clinical scholarship thus build on the core concepts of applied epistemology: the study of knowledge and justified belief. Yet clinical training does not routinely teach these concepts. Working with the Society for Academic Primary Care, we are therefore establishing a new SAPC Special Interest Group in Clinical Epistemology to plug that gap.