ABSTRACT
The notion of a ‘specialist’ within general practice (GPwSI) may seem like a contradiction. This chapter attempts to clarify the potentially blurred professional boundaries between ‘generalism’ and ‘specialism’. There has been much debate about GPwSIs in the literature, particularly by making cost comparisons with consultant consultations and patient satisfaction. Some studies suggest that GPwSI services are significantly more costly to the health service than secondary care for broadly similar clinical outcomes, with caveats that the financial costs be balanced against the benefits of advanced access for patients. The striking difference is that a GPwSI is not a specialty or job in its own right, but an extended role that compliments that of a general practitioner. Some may argue that the concept of a GPwSI is something that has existed in general practice for many years; ‘GPwSI’ being merely a new title for practitioners who have had a special interest or clinical experience in a particular field for a long time.
