Being a “generalist” – the best job in the world

David VK Chao 周偉強

HK Pract 2015;37:121-122

In most people’s mind, gaining an entry into medical school is a big step in life. Then, before you know it, the time comes that we have to choose what we do for our medical career - choosing of specialty training. How would one choose a specialty that is right for him or her?

I read with interest that a colleague, Dr Rodger Charlton, has just been interviewed and a succinct message has been written about what he thinks of being a "generalist" in the United Kingdom.¹

Dr Charlton, a United Kingdom general practitioner (GP) in the West Midlands and Professor of Primary Care Education at the University of Nottingham, described that general practice is the best job in the world and he mentioned his top ten reasons to be a GP in the United Kingdom. Some of these reasons are quite applicable to the local primary care practice setting in Hong Kong.

First off the line, being a "generalist" can have remarkable “job satisfaction in the continuity and personal nature of the care you provide - patients refer to you as 'my doctor'”.¹ This is due to the “from cradle to grave” care that GPs, or we in Hong Kong also known as family physicians provide, day in and day out. Over time, getting to know the patient and his/her family and the building up of good rapport with them can help us to better involve the patient and his/her carers in the care management plan.

Due to our highly advantageous position in the community, GPs and family physicians are well placed to be the first contact of patients who are seeking medical help. We see patients from all walks of life with a wide spectrum of presentations and conditions. Nothing is general about general practice – “it is not just about coughs and colds, a GP or family physician (FP) is managing complex conditions”.¹ As described perfectly well by Dr Charlton, “every day is different and interesting”.

As a primary care doctor, we see the patient gets better, or would be there to provide support and comfort when he or she does not. More often than not, in these days, a multidisciplinary approach to managing diseases may be needed, especially for many chronic conditions. This is an important role of a GP/FP being the patient's advocate and a companion on many life journeys.

Great job flexibility exists within the realm of family medicine. One can choose to be a full-timer, part-timer, pure clinician, pure academician, or somewhere in between either in public or private sector. One can even organise his/her own training and/or “rotational schemes” over time to have various exposures in different settings. With the advent in ambulatory care, opportunities exist for family physicians also to become “a FP with a special interest” in a desired field.

In his recent interview article, Dr Charlton mentioned that he is still excited about general practice 30 years on.¹ If you are already in family practice, lucky you! If you are contemplating what medical career choice to have and feel that you enjoy continuity of care, seeing a variety of different conditions and challenging scenarios in the community setting, family medicine or becoming a "generalist" should be right for you!