Organisation and design of healthcare for generalism

This chapter examines how traditional, existing and future healthcare systems can support or undermine generalism in practice. We discuss current issues within UK general practice, although our reflections and suggestions on the crucial contribution of generalism to healthcare systems are by no means limited to this context. The relevance of generalism within all healthcare systems is emphasised. We provide historical examples from medicine with relevance to generalist clinical learning and practice today and beyond. Drawing on Don Berwick’s seminal paper published in 2016 ‘Era 3 for Medicine and Health Care’ (1), we describe how the ‘epic collision of two eras