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Generalism as Intention
Rosemary Stevens said it well: “As a would-be ‘general specialty,’ internal medicine has been in constant search of its own definition” (1). In this issue, Larson and the Society of General Internal Medicine (SGIM) Task Force on the Domain of General Internal Medicine (2) attempt to define generalism, with a list of skills to be acquired and potential reforms of payment and education that might help to realize their definition. As a mid-career practitioner engaged in community-based, independent medical practice, I agree with what they say, but there is a dimension I'd like to add. Something essential about generalist practice is missing from a description focused on core skills of the generalist.
In my …
