Focus | Clinical © The Royal Australian College of General Practitioners 2023 428 Reprinted from AJGP Vol. 52, No. 7, July 2023 Johanna M Lynch, Hayley R Thomas, Deborah A Askew, Nancy Sturman Background Generalist work is often complex, especially in the face of undifferentiated, uncertain, uncomfortable or unremitting presentations. This complexity can be exacerbated by difficult social circumstances and health system constraints, as well as by dissonance between patient and clinician conceptions of ideal care. Objective This article offers philosophical and practical encouragement to help general practitioners (GPs) ‘be with’ patients, care for their own needs and value their complex work. Discussion Caring for the whole person is challenging. When done well, this complex care may look simple. Alongside biomedical knowledge, generalists require sophisticated relational sensitivity and capacity to notice and attend to context, culture, meaning and subjective inner experience, including the person’s strengths and deepest fears. Generalist philosophy, priorities and clinical skills are named in this paper as part of the ongoing effort to help GPs value, hone and protect the often-misunderstood complexity of their work. THERE IS AN URGENT NEED to clarify the value and expertise of generalist approaches in healthcare, especially as general practice faces demoralisation of the general practitioner (GP) workforce 1,2 and changes in primary healthcare policy and structures. ‘Generalism’, defined as ‘expertise in whole-person care’, 3 integrates biological and biographical knowledge and offers person-centred care, as well as continuity of care. 3 This is challenging work that relies on generalist philosophy, priorities and practical skills. There are relational and contextual challenges to generalist person-centred care in every clinical encounter. GPs intentionally sit near the pain, suffering and uncertainty in their communities, seeking to offer healing relationships that are humane and respectful. They become aware of social isolation, overwhelming financial needs and lack of timely access to affordable medical care. GPs often respond with innovative care, 4 political advocacy 5 and financial and personal generosity, such as seeking further training or working longer hours, bulk-billing and other unpaid work to increase access to care. This very same generosity can develop into distress or internal conflict if taken for granted of if the patient or community complains, asks for care that is not medically indicated or crosses the personal boundaries of the GP. 6,7 Generalist care is undermined by systemic and bureaucratic devaluing of GP time and expertise, primary care policy that fragments care and encourages short transactional encounters and an excessive focus on disease or procedures. 8,9 Clinical decision making in the face of uncertainty, undifferentiated symptoms, conflicted goals or chronic disease and grief is also cognitively, emotionally and morally difficult. 10,11 In order to protect GPs from doubting the value of their work, 12–14 it is important to understand generalism as so much more than biomedical service provision: it requires philosophical attitudes, overarching priorities and practical skills that are often unnamed and unnoticed. In this article we offer encouragement to GPs by clarifying the nature and value of generalist work and by describing some practical priorities and skills that are part of the generalist toolkit. Valuing the work of general practice: The Craft of Generalism The ‘Craft of Generalism’ named in this paper (and outlined in Figure 1) aligns with generalist and transdisciplinary philosophical approaches to knowledge, 15,16 as well as with ‘clinical pragmatism’. Clinical pragmatism is a philosophically robust approach to knowing that values Holding the complex whole Generalist philosophy, priorities and practice that facilitate whole-person care