More ‘generalists’ needed in healthcare

Published: 18 Sep 2017

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The Deans of Singapore’s three medical schools highlighted the importance of training more “generalist” doctors, who are specialists in fields such as geriatrics or internal medicine, where the focus is typically on the patient as a whole – rather than a specific organ or body part.

In a recent speech, the Ministry of Health’s (MOH) director of medical services Benjamin Ong also urged medical students to consider family medicine as a career. In this field, doctors are trained to manage all kinds of patients – with different ages and health issues – outside the hospital.
“Increasingly, I think that’s what we need in the health system – we need generalists,” said Associate Professor Yeoh Khay Guan, Dean of NUS Medicine. “It’s not very good if our elderly parents see five doctors. It’s better if there’s also a generalist to look after their needs.” The generalist doctor would then call in specialists if there was a need, so the patient would not have to deal with too many doctors.
However, it is still an uphill task for the healthcare system to attract young doctors into these fields for a number of reasons.

There is a certain glamour attached to the word “specialist”, and an implicit bias against the “generalist” who is assumed to be a jack of all trades.

Junior doctors may also not have the opportunity to experience “generalist” fields as they have to decide on a speciality immediately after graduation.

Some solutions include introducing more diversity in medical training, while keeping the existing model intact, and upskilling other health professionals to shoulder some of the load of generalist doctors.

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