"Jack of all trades, master of none,
Certainly better than a master of one"
To argue whether a generalist is more valuable than a specialist is to miss the point that each has their place. Such polymaths as Leonardo da Vinci, who had skills spanning the arts and science, lived in an age of liberalising Renaissance thought, which viewed people as having limitless capabilities. Such a notion nurtured enablement of individuals to develop themselves and avoid the limitations often imposed by an oppressive body of conservative opinion.
Within the sphere of health the debate about specialism is further complicated by the notion that the body cannot be considered as a machine to be divided into different functions, but has to be considered as a whole. In this respect specialisms that deal with only one aspect of bodily function are to an extent arbitrary distinctions; it can be viewed that such a divisive process can undermine natural homeostatic mechanisms. Far more persuasive however, is the fact that critical actions are often necessary and this should be performed efficiently by a professional whose skill in the specific task is developed as fully as possible. The generalist is well-placed to apply the knowledge they have, to know when this is not sufficient and refer to an appropriate specialist when needed.
There is an increasing realisation that as a nation our capabilities to provide therapies outstrips our ability to pay for them within the NHS. This is an uncomfortable truth to politicians whose interests lie in promoting the perception that limitless care can be provided. It is also uncomfortable as a GP, as the consideration of resources impinges more and more upon the therapeutic relationship. The role as patient advocate is increasingly balanced (to be frank) with the desire to make financial savings and indirectly boost the personal share of business profit.
To conclude there is an ever increasing value to an independent advocate, who is able to engage alongside (and also think beyond) the limitations of conventional medical care. Who can enable sound decision making, have more time to provide holistic care and draw on knowledge of an expanded range of evidence-based therapies; enter the Health Consultant.
