Stuart Handysides's series of articles on enriching careers in general practice (the sixth and last of which is published today (p 513)) has amassed many facts and useful opinions about the state of general practice today.*RF 1-6* The accelerating pace of change makes the beginning of 1994 a good time to take stock.

Handysides correctly identifies the current importance of morale, career development, inevitable change, partnerships, teamwork, and management in general practice. The question we must answer is, how can we sustain the challenge and privilege of being personal doctors in the front line of a cash limited health service when more and more is being asked of us by professional bodies, the government, and patients? We offer six approaches that seem both theoretically sound and practical in aiding enjoyment of ordinary NHS general practice.

Firstly, we think and practise as “generalists,” a …