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General practice's last stand

BMJ 1995; 310 doi: (Published 17 June 1995) Cite this as: BMJ 1995;310:1613
  1. D P Kernick

    Adiscussion document from the BMA's General Medical Services Committee, which was circulated in July, defines the core content of general practice. The intention is to ensure that all general practitioners provide a basic standard of service and are able to choose which non-core services are provided at an appropriate level of additional remuneration. Future social historians will identify this document as a milestone in our professional decline. Not unlike General Custer a hundred years ago, it is general practice's last stand—heroic, futile, misconceived, and with the same inevitable conclusion.

    The paper suggests that our core professional area is to respond to the “timeless human need” of managing real and perceived illness. “This aspect of human behaviour transcends history, geography and culture and will survive the ephemeral health policies of transient governments.” Unfortunately, this superficial use of metaphor fails to appreciate the real world as it analyses our “sovereign professional territory.” The government is not transient but a permanent phenomenon in that its actions reflect changes in society, both economic and sociological.

    This naive use of metaphor is again shown by one of the …

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