Generalism in Family Medicine: A WONCA Sydney 2023 Research Project

WONCA is keen to announce the recent publication of a paper written by key WONCA members reflecting on data gathered from a vibrant workshop at WONCA Sydney 2023. The workshop, entitled 'The Generalist Gaze: making visible the generalist skills at the heart of quality health care', invited participants to reflect together on what it means to be a family doctor. The resulting paper was published by Annals of Family Medicine on 27 July 2026.

International Generalist Physicians’ Conceptions of Generalism: “The Way,” “The Privilege,” and “The Indescribable Whole” The Annals of Family Medicine July 2026, 24 (4) 342-349; DOI: https://doi.org/10.1370/afm.250468

This work is built on the scholarship of many family doctors globally, who have worked over decades to name the sometimes difficult to describe skills and attitudes of generalism. The team included eminent generalist researchers from the United States (Professors Kurt Stange, Larry Green and Rebecca Etz) and Canada (Professor Martina Kelly), and was led by Associate Professor Johanna Lynch, a member of the WONCA Core Values team and Mental Health Working Party, with Adjunct Professor Karen Price, former President of the Royal Australian College of General Practitioners (RACGP) and past member of the WONCA Executive. Ethical approval for this research came from the RACGP.

Perhaps because general practitioners on the frontline are very aware of public policy that undermines the relational heart of our work, the hundred-seat room filled to capacity and we had to turn people away at the door. Many leading thinkers and writers who understand what is at stake if generalism loses its place in healthcare filled the room with a buzz of conversation.

In preparation for this conference, a set of interviews were recorded with GPs from Australia, Japan and the USA and collated into a set of video prompts entitled 'A love letter to generalism'. This video is freely available to encourage family physicians, and can be viewed on Dr Johanna Lynch's website.

Analysing the data was not straightforward, as so many elements of the craft of generalism can be overlooked if the data is examined looking for what we already know about family medicine from the earlier work of Barbara Starfield and Kurt Stange. We found ourselves seeing people describing our work in metaphors as 'a black box' and 'like doing laps in the ocean', the most evocative and poignant in light of current policy:

"Generalism is important but undervalued—like the mum of the family—thinking about all of the logistics—pre-emptive care—the most lost when it is gone—taken for granted but also most-loved." (participant C1)

At one stage in the analysis we searched for ways to understand the emotion and meaning in the words. One of our team wrote a poem called 'The Gift of Generalism', as a response and prompt. It was published in 2025 by Family Practice.

Finally, after years of reflection and refining, the paper from this WONCA workshop is being published. We are hopeful this work will encourage and strengthen family medicine across the WONCA family. Three main themes emerged: the way of being of the generalist (which included sub-themes in participants' words of 'anything and everything', 'putting all the pieces back together', 'walking the journey together', and 'widening my small world'); the privilege of emotional connection and gratitude toward patients in meaningful work; and the indescribable whole, the valuable, often invisible and misunderstood essence of generalism.

This research speaks to the integrative, relational, and holistic work of the generalist physician. The depth of meaning, care, and devotion expressed by participants was humbling, and it underscored how often these qualities are overlooked in modern health system and policy design. Recognising and supporting this dimension of generalist care may help sustain healthcare systems that are becoming increasingly fragmented and impersonal. Its loss, conversely, risks undermining the wellbeing of health systems already under considerable technological and economic pressure.

We are grateful to WONCA, the Royal Australian College of General Practitioners, and above all to the participants from around the world who gave so generously to a profession they clearly love.

Authors

Dr Johanna Lynch, Associate Professor, General Practice Clinical Unit, Medical School, The University of Queensland.

Adjunct Professor Karen Price, past President of the RACGP (2020 to 2022), former WONCA Executive Committee Member-at-Large (2023 to 2025).