Dear editor
We have read the article by Hirata et al.1 We, the two authors of references 1 and 9 cited in the background of this article, are Japanese physicians practicing general medicine (GM) and have been thinking about the nature of GM and generalists. This paper is a very important and new perspective from which to develop future research on GM.
However, it should be noted that, at least in Japan, a distinction should be made between considering the definition of GM and the definition of generalists (Figure 1).2 If we were to consider the definition of generalists, we would need to broaden the scope of consideration beyond the physicians mentioned in this paper. For example, emergency physicians, intensivists, and palliative care physicians combine comprehensiveness in their practice. Whether or not they should be included as generalists would be one of the points to consider when considering the definition of generalists in Japan.2
Figure 1.
In Japan, “Generalist” includes “General Medicine (GM) Physician” as well as various doctors.
Also, trying to translate GM into Japanese would probably result in “Sogo-Shinryo-I”,3 but this concept is not always synonymous with generalists. To avoid this confusion, one of us, in an earlier paper, referred to doctors practicing GM in Japan as “general medicine physicians”.2 We believe that when defining GM and generalists, attention should be paid to the differences between Japanese and English expressions as well as to the differences in cultural background.
In addition, the article by Hirata et al,1 as written in the Limitations section, is truly an expert opinion, co-authored by experts who belong to the general medicine departments of university hospitals and the committee to discuss about board certification of hospitalists in Japan. Consideration should also be given to the fact the board certificate system of GM in Japan is currently in a period of transition, with each generation having a different perspective. Younger Japanese physicians may also feel differently from the experts.
We hope that generalists from various positions can join hands and discuss what qualities and competencies are required for the development of GM.
Disclosure
The authors report no conflicts of interest in this communication.
References
- 1.Hirata R, Tago M, Shikino K, et al. Standardizing generalist definitions to improve evidence in general medicine: addressing diverse interpretations and lack of consistency. Int J Gen Med. 2024;17:2939–2943. doi: 10.2147/IJGM.S468755 [DOI] [PMC free article] [PubMed] [Google Scholar]
- 2.Yokota Y, Watari T. Various perspectives of “general medicine” in Japan-Respect for and cooperation with each other as the same “general medicine physicians. J Gen Fam Med. 2021;22(6):314–315. doi: 10.1002/jgf2.500 [DOI] [PMC free article] [PubMed] [Google Scholar]
- 3.Otsuka Y, Obika M, Otsuka F. Inconsistency of the “Sogo-Shinryo” department in Japanese hospitals. J Gen Fam Med. 2022;23(3):201–202. doi: 10.1002/jgf2.522 [DOI] [PMC free article] [PubMed] [Google Scholar]