Developing generalism in the South African context

Amanda C Howe, Robert J Mash, Jannie F M Hugo


The largest impact on the South African burden of disease will be made in community-based and primary healthcare (PHC) settings and not in referral hospitals. Medical generalism is an approach to the delivery of healthcare that routinely applies a broad and holistic perspective to the patient’s problems and is a feature of PHC. A multi-professional team of generalists, who share similar values and principles, is needed to make this a reality. Ward-based outreach teams include community health workers and nurses with essential support from doctors. Expert generalists – family physicians – are required to support PHC as well as provide care at the district hospital. All require sufficient training, at scale, with greater collaboration and integration between training programmes. District clinical specialist teams are both an opportunity and a threat. The value of medical generalism needs to be explained, advocated and communicated more actively. 

Authors' affiliations

Amanda C Howe, University of East Anglia, UK; Royal College of General Practitioners; World Organization of Family Doctors

Robert J Mash, Family Medicine and Primary Care, Stellenbosch University, South Africa; African Primary Healthcare and Family Medicine Journal; National Education and Training Committee for the South African Academy of Family Physicians, South Africa

Jannie F M Hugo, Department of Family Medicine at the University of Pretoria, South Africa

Full Text



family medicine; generalists; medical generalism; primary healthcare; workforce

Cite this article

South African Medical Journal 2013;103(12):899-900. DOI:10.7196/SAMJ.7509

Article History

Date submitted: 2013-09-16
Date published: 2013-10-11

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