Rethinking generalist health care: opportunities from challenges

[摘要] Health Education England describes a vision of future health care built on whole-person, generalist care.1 But, if this is to succeed, we must first address some misconceptions about medical generalism. My team have been working on three.NOT ‘SOFT SKILLS’ BUT ‘TAILORED CARE’ Ask someone, ‘What is person-centred care?’ and they commonly describe the importance of the so-called ‘soft skills’ — communication, empathy, relationship-based care. These certainly matter — research and clinical experience confirm the therapeutic value of relationships. But it was a patient who made me think again. Let’s call her Helen.2 Helen was dying from breast cancer. She was a busy wife, mother, employee. Terminal cancer had turned her daily life upside down. Helen spoke movingly about how much she valued her relationships with her clinical team. Their empathy, care, and understanding of her illness as being ‘more than about cancer’ created invaluable personal care. But she criticised the same professionals for their failure to translate personal care into personalised health care: ‘… they do listen, but they don’t think they need to take notice’. She talked of professionals repeatedly offering ‘evidence-based’ justifications for clinical decisions, but being apparently unable (or unwilling) to create tailored approaches. This left Helen feeling ‘… stuck on a conveyor belt’.Helen’s story highlights that personal care — soft skills — are important, but insufficient. Person-centred care also needs personalised, beyond disease-guideline, care: a model of practice that is anything but ‘soft’.

[学科分类] 卫生学