General practice will develop best if “caring” is replaced by professionalism

EDITOR—Mackenzie's hypothesis that the term “the caring doctor” is an oxymoron struck a chord with many doctors I speak to.1 I have long thought that general practice will develop best if we replace the sham of caring with better professionalism. This does not stop us practising good medicine in a compassionate and considerate manner. We spend a lot of time teaching consulting skills to registrars. Good consulting is not the same as “niceness,” and the term “the caring professions” is patronising and arrogant.

There is still a place for the registered list of patients, but in a computerised world it is a tool for targeting and delivering good medicine—for example, in secondary prevention. The modern world is demanding of us. If general practice is to remain vibrant and attract high quality recruits we have to develop practice beyond the personal attributes of individual doctors. We need to think imaginatively, to continue the drive for better organisation, to use information technology to the full, to recognise the strengths of other members of the team, to delegate and give up some of our traditional perceived duties to those who often do them better. Surely routine visiting is a thing of the past.

Practitioners as team leaders need to have the time and energy to step back and look critically at what the practice does as a whole and not to be afraid to initiate change. Too much of what we do still depends on tradition rather than planning. This opens the doors to external influences, as we have seen in the past few years to our disadvantage.

Clinical audit should no longer be a threat to most of us, and …