TY - JOUR T1 - Dismantling Lord Moran’s ladder: the primary care expert generalist JF - British Journal of General Practice JO - Br J Gen Pract SP - 34 LP - 35 DO - 10.3399/bjgp13X660823 VL - 63 IS - 606 AU - Joanne Reeve AU - Greg Irving AU - George Freeman Y1 - 2013/01/01 UR - http://bjgp.org/content/63/606/34.abstract N2 - ‘It’s not a choice for me to be a generalist. I would have liked to have done something more.’ (Early career doctor)1It is over 50 years since Lord Moran suggested that GPs were doctors who have fallen off the specialist ladder.2 Then, two-thirds of early career GPs would have preferred to have been specialists.2 Today Lord Moran’s ladder lives on. General practice is still not a first career choice for many graduates, certainly not enough to sustain the workforce we need.3 Our conversations with early career medics reveal that they value the opportunities for flexible working within general practice. But also that they want ‘something more’ than the GP role: notably, opportunities to develop ‘special interests’. We suggest this represents a failure to recognise, or value, the specific expertise of the GP role itself; and in particular a misunderstanding of the primary care expert generalist approach.We start by considering what we understand by the expert generalist. The role is defined by two elements. First, a principle of personalised decision making which recognises health as a resource for … ER -