A historical perspective of the barriers to generalism

作者：Lee Kheng Hock^*

来源：Australian Family Physician, 2015, 44(3): 154-158.

• general practice
• health policy
• history of medicine
• primary care
• rural health services

Background
As early as the late 19th century, there were calls to give greater emphasis to general practice. The momentum picked up after the Second World War. The voices calling for more generalism reached a crescendo in the late 1960s. Optimism was very high in the following two decades. Today, there is a pervasive sense of lost opportunity as generalism continues to languish behind the increasing momentum of specialisation of medicine.
Objective
This article is a view of generalism through the lens of history. It seeks to understand and draw lessons from the slow progress of generalism in the light of the forces that have shaped its development through the years.
Discussion
The tensions between sectors that promote generalism continue to this day. The ongoing antagonism between the plough, the town and the gown remains a dominant factor that shapes the path to generalism. Political activism seems to be an effective tool in promoting greater generalism.

• 出版日期2015-3