Perspectives on expert generalist practice among Japanese family doctor educators: a qualitative study.

Makoto Kaneko,Noriaki Sawa,Yasuki Fujinuma,Greg Irving,Ai Oishi

doi:10.3399/bjgpo.2021.0011

Abstract

BackgroundExpert generalist practice (EGP) is increasingly being viewed as the defining expertise of generalist care. In Japan, several prominent family doctors consider it important and relevant in the Japanese context. However, no study has examined Japanese family doctor educators’ perceptions of EGP.AimTo explore Japanese family doctor educators’ perceptions of EGP.Design & settingA qualitative study among family doctor educators in Japan.MethodFocus group interviews were conducted using a semi-structured interview guide following a short lecture on EGP. A qualitative description method was adopted and the framework method was used to conduct thematic analysis.ResultsParticipants were 18 family medicine doctor educators, including 11 directors and six associate directors of family medicine training programmes. The results suggested that the concept of EGP was important and applicable to primary care in Japan. Participants’ perceptions on EGP pertained to the following four areas: impact of EGP, triggers for EGP, enablers for EGP, and educational strategies for EGP.ConclusionThe concept of EGP may be useful in clinical practice in Japan, especially in complex patient care. A clearer framework for or description of EGP, and of non-traditional methods, such as ascetic practice and awareness of the self, were proposed as possible educational strategies.

Highlights

Specialists and medical students, as well as family doctors themselves, repeatedly ask the question, ‘What is the expertise of family doctors?’1–4 One answer is the concept of Expert generalist practice (EGP), proposed by Reeve et al[5] in the UK, where family doctors make up the largest group of medical generalists
What is the significance of EGP? Would EGP have any impact on primary care in Japan? Do you think you practise EGP? If so, in what situations? How would you teach EGP? Do you teach it? Are there any barriers to practising or teaching EGP? How do you overcome these barriers? What would you like to learn about EGP? What would you like to add to the EGP lecture we presented today?
There are voluntary training programmes and examination for family doctors, which is managed by the Japan Primary Care Association (JPCA), the Japanese professional body of family medicine.[10]

Summary

Introduction

Specialists and medical students, as well as family doctors themselves, repeatedly ask the question, ‘What is the expertise of family doctors?’1–4 One answer is the concept of EGP, proposed by Reeve et al[5] in the UK, where family doctors make up the largest group of medical generalists. No study has examined Japanese family doctor educators’ perceptions of EGP. Aim: To explore Japanese family doctor educators’ perceptions of EGP. Design & setting: A qualitative study among family doctor educators in Japan. The results suggested that the concept of EGP was important and applicable to primary care in Japan. Conclusion: The concept of EGP may be useful in clinical practice in Japan, especially in complex patient care. A clearer framework for or description of EGP, and of non-traditional methods, such as ascetic practice and awareness of the self, were proposed as possible educational strategies

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Conclusion