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Generalism and specialism: Reasserting the value of specialist knowledge in an era of multimorbidity
Waqas Akhtar1, Luigi Camporota1
1Guy's & St Thomas' NHS Foundation Trust, Westminster Bridge Road, London SE1 7EH, United Kingdom.
Abstract:
Emphasis has increasingly been placed on expanding medical generalism in response to an ageing population and the rising prevalence of multimorbidity. While the ability to manage complex, undifferentiated illness across multiple conditions is undeniably important, modern healthcare is simultaneously becoming more technologically advanced and clinically specialised. Breakthroughs in diagnostics, therapeutics and procedural medicine demand deep, focused expertise to deliver safe and effective care, particularly for high-risk patients. Rather than viewing generalism and specialism as competing models, healthcare systems must recognise them as complementary. Generalists are essential for holistic assessment, coordination and continuity, while specialists provide advanced interventions and nuanced disease-specific management. In an era defined by both multimorbidity and rapid medical innovation, the central challenge is not to prioritise one approach over the other, but to strike an appropriate balance which ensures that patients receive the right expertise at the right time.
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