Generalism as a cross-disciplinary practice in medicine: Mixed-studies systematic review

Area of Science:

• Medical Practice
• Healthcare Systems
• Physician Roles

Background:

• Generalist physicians play a crucial role in healthcare delivery.
• The definition and characteristics of generalist practice remain unclear across medical disciplines.
• Understanding generalism is essential for optimizing healthcare systems and professional development.

Purpose of the Study:

• To define generalist physicians and characterize their practice.
• To identify common attributes and archetypes of generalist practice.
• To provide a framework for cross-disciplinary dialogue on generalism.

Main Methods:

• Systematic review of empirical studies (quantitative, qualitative, mixed methods).
• Searched multiple databases including MEDLINE, PsycInfo, SocINDEX, Embase, Ovid HealthSTAR, Scopus, and Web of Science.
• Included 262 studies from 25 countries describing generalist physician attributes.

Main Results:

• Forty-seven percent of studies lacked essential participant information.
• Generalism was often defined by the absence of specialist training (a "deficit model").
• Four archetypes of generalist practice were identified: broad-based knowledge, adaptive expertise, integrative expertise, and interpretive expertise.

Conclusions:

• Generalism lacks a consistent definition across clinical disciplines.
• Four proposed archetypes can promote cross-disciplinary dialogue.
• These archetypes can guide the design of future healthcare systems and professional roles.