Just to continue our effort to be disruptive. We are advocating for a new and expanded role for the primary care generalist.

It is much more difficult to be a primary care generalist than an ENT surgeon exploring sinuses or an eye surgeon replacing lenses.

Specialists are said to learn more and more about less and less until they know everything about nothing.

Primary care generalists keep learning more and more about many things until they know something about everything that impacts the patient.

The trend is evolving that places the primary care generalist at the centre of patient care and pays the primary care generalist at equal rates to all of the specialists.

But this will require rethinking the processes and metrics that have come to dominate primary care and instituting changes that place more emphasis on the patient-physician relationship.

Three places to start this reform process are:  the payment model, fixing EHR technology, and changing medical education.

Primary care generalists should earn as much or more than many specialists.

EHR technology must be made much easier to use and it must serve the doctors by presenting useful data and insights.

And the medical education has to focus on the many skills required by the primary care generalist instead of the primary care doctor being a watered down version of a specialist.