Frectally speaking

This paper by Health Education England is one that caught my eye.

The longer title is “ The Future Doctor Programme; A co-created vision for the future clinical team” but the short bottom line version is the doctor of a future is a generalist.

While we have seen major shift to specialisation and subspecialisation in healthcare in recent decades, when the pressure came on during the recent pandemic outbreak, it was the basic/general skills of doctors that was called upon. Ensuring it was safe to approach the patient, assessing patients for signs of illness, offering treatment (often simply Oxygen initially).

It was also a time when the value of generalists came into their own so the speciality of emergency medicine (where I hail from) came into its own , often as the front door for all cases where quick and urgent decisions had to be made, albeit and with due respect to anaesthetic/ICU colleagues.

Beyond the most recent crisis challenge though, this paper highlights some key issues going forward. Though this paper was in planning ahead of this crisis , the most recent crisis has made all the key issues more pertinent than ever. Here I have highlighted a few of the key points made

Patient-Doctor Partnership
Doctors in the future clinical team have the patient firmly front and centre to promote supported shared-decision making and enable patients to make the best use of available care and support

The Extensivist and Generalist
Future Doctors will have confidence in a greater breadth of practice across
disciplines and specialties due to a strong base of generalist skills, which will enable them to deliver complex, comprehensive care managing co-morbidities in changing healthcare environments.

Leadership, Followership and Team Working
Future Doctors will demonstrate compassionate and collaborative leadership and effective teamworking.

The Transformed Multi-professional Team
Future Doctors will espouse and promote a culture where each member of the multi-professional team is acknowledged, respected, valued and empowered to accept shared responsibility. Doctors will promote other healthcare roles to patients and the public.

Population Health and Sustainable Healthcare
Future Doctors will learn, while embedded in their local community, to better understand population needs and use resources optimally to improve the physical, mental and social wellbeing of the whole population. They will embrace a culture of stewardship and a sense of community responsibility.

Adoption of Technology
Technology will be employed by Future Doctors as an enabler for change in
clinical care and in education (e.g. remote supervision and care delivery and AI augmenting clinical decision making)

As a medical doctor/emergency physician who has evolved into an advocate for change/leadership/management, information technology and sustainable economics, I have to wholeheartedly endorse this view, doctors as generalists is the way to go!