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Holding the complex whole: Generalist philosophy, priorities and practice that facilitate whole-person care
Johanna M Lynch1, Hayley R Thomas2, Deborah A Askew3
1MBBS, PhD, GradCert, FRACGP,@FASPM, Senior Lecturer, General Practice Clinical@Unit, The University of Queensland, Brisbane, Qld.
Background:
Generalist work is often complex, especially in the face of undifferentiated, uncertain, uncomfortable or unremitting presentations. This complexity can be exacerbated by difficult social circumstances and health system constraints, as well as by dissonance between patient and clinician conceptions of ideal care.
Objective:
This article offers philosophical and practical encouragement to help general practitioners (GPs) 'be with' patients, care for their own needs and value their complex work.
Discussion:
Caring for the whole person is challenging. When done well, this complex care may look simple. Alongside biomedical knowledge, generalists require sophisticated relational sensitivity and capacity to notice and attend to context, culture, meaning and subjective inner experience, including the person's strengths and deepest fears. Generalist philosophy, priorities and clinical skills are named in this paper as part of the ongoing effort to help GPs value, hone and protect the often-misunderstood complexity of their work.
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