John Launer: Seeing the big picture—the distinctive value of generalism

Patients are often the beneficiaries of medicine, but they can be its victims too. Most people in the western world are likely to know by their 60s that they have at least one chronic condition or risk factor, if not several. As they age further the number of these will almost certainly increase, along with regular check-ups, investigations, and an escalating amount of treatment.Some of the effects of this may be positive in terms of a person’s longevity and quality of life, although good nutrition, housing, education, and a decent income are likely to have been more important. Over time, however, their risks of harm will also become greater. These may include an altered self-image, the iatrogenic effects of overdiagnosis and polypharmacy, and a paradoxical lessening of their overall enjoyment of everyday living.Many interconnected cultural influences have led us to this. One important strand has been the growth of medical…
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