Back to the future: A call to generalism in psychiatry

IntroductionProviding a sustainably resourced medical workforce to meet the healthcare needs of a population is a significant challenge. Drivers of medical workforce issues include an ageing population, increasing chronic disease, skill shortages and workforce maldistribution. In this paper, we consider the imbalance between generalism and specialism in Australia, arguing that generalist positions may better address the current healthcare gaps.Analysis and evidenceWe describe generalism in the broad Australian healthcare system before exploring generalism within psychiatry and reflect on how lessons learned in rural generalist psychiatry can be applied to broader medical workforce reform.DiscussionThe imbalance between specialism and generalism within the mental health workforce across settings must be re-examined given the increased burden of disease and patient complexity. An explicit articulation and recognition of generalism within psychiatry may yield positive results on workforce development and ultimately accessibility of psychiatric services across geographical and service delivery settings.ConclusionAdvocating for generalist psychiatry, alongside general practice, to be at the centre of workforce solutions into the future is more critical than ever. The profession must give generalist psychiatry the recognition it deserves, lift its professional status and prioritise its training before we lose our authority and our social licence.