ArticleBMC family practice2013
Generalist solutions to complex problems: generating practice-based evidence--the example of managing multi-morbidity.
Article in BMC family practice, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 36 papers, 2 of them syntheses that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
36 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Pooled it
- Factors influencing subspecialty choice among medical students: a systematic review and meta-analysis.BMJ open · 2019Pooled it
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- Rethinking Symptom Fluctuation in Multimorbidity: A Dynamic Systems Framework From Primary Care.Journal of evaluation in clinical practice · 2026Article
- International Generalist Physicians' Conceptions of Generalism: "The Way," "The Privilege," and "The Indescribable Whole".Annals of family medicine · 2026Article
- Cognition in the Clinic: The Case for Cognitive Ethnography in Family Medicine.Family medicine · 2026Article
- Article
- Developing sustainable generalism education in community settings: Insights from the JPCA (Japan Primary Care Association) Conference, 2024.Journal of general and family medicine · 2025Article
- The implementation and evaluation of the Ontario COVID@Home Clinical Primary Care Pathway.Family practice · 2025Article
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- The magnitude of influence of personal and professional factors on the career choices of medical students.Journal of medicine and life · 2024Article
- Addiction Medicine and Psychiatry Workforce Training and Planning across Australia and New Zealand: Commentary on "Education and Training in Addiction Medicine and Psychology across Europe: a EUFAS Survey".European addiction research · 2024Article
- A systems approach to the safety and efficiency of prescribing at the primary-secondary care interface.Future healthcare journal · 2023Article
- Communication skills of general practitioners in Nairobi, Kenya: a descriptive observational study.BJGP open · 2022Article
- Psychometric properties and measurement invariance of Short-Form Life Attitude Inventory for hospital staff.BMC medical education · 2022Article
- Perspectives on expert generalist practice among Japanese family doctor educators: a qualitative study.BJGP open · 2021Article
- Patient and GP experiences of pathways to diagnosis of a second primary cancer: a qualitative study.BMC cancer · 2021Article
- Practical wisdom in complex medical practices: a critical proposal.Medicine, health care, and philosophy · 2019Article
- Revitalising general practice: unleashing our inner scholar.The British journal of general practice : the journal of the Royal College of General Practitioners · 2017Article
- Elaboration of the Gothenburg model of person-centred care.Health expectations : an international journal of public participation in health care and health policy · 2017Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
9 authors.
Funding
Abstract
backgroundA growing proportion of people are living with long term conditions. The majority have more than one. Dealing with multi-morbidity is a complex problem for health systems: for those designing and implementing healthcare as well as for those providing the evidence informing practice. Yet the concept of multi-morbidity (the presence of >2 diseases) is a product of the design of health care systems which define health care need on the basis of disease status. So does the solution lie in an alternative model of healthcare? DISCUSSION: Strengthening generalist practice has been proposed as part of the solution to tackling multi-morbidity. Generalism is a professional philosophy of practice, deeply known to many practitioners, and described as expertise in whole person medicine. But generalism lacks the evidence base needed by policy makers and planners to support service redesign. The challenge is to fill this practice-research gap in order to critically explore if and when generalist care offers a robust alternative to management of this complex problem. We need practice-based evidence to fill this gap. By recognising generalist practice as a 'complex intervention' (intervening in a complex system), we outline an approach to evaluate impact using action-research principles. We highlight the implications for those who both commission and undertake research in order to tackle this problem. SUMMARY: Answers to the complex problem of multi-morbidity won't come from doing more of the same. We need to change systems of care, and so the systems for generating evidence to support that care. This paper contributes to that work through outlining a process for generating practice-based evidence of generalist solutions to the complex problem of person-centred care for people with multi-morbidity.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.