Ian RichardsonBMJ 2011; 342 doi: http://dx.doi.org/10.1136/bmj.d2679 (Published 27 April 2011) Cite this as: BMJ 2011;342:d2679
- Lewis Ritchie,
- John Howie,
- Denis Pereira Gray
Qualifying with MB ChB honours from Edinburgh University in 1944, Ian Richardson was one of the most respected and influential of the first wave of UK professors of general practice. He first aspired to be a surgeon, but was thwarted by severe skin allergy problems. He obtained his MRCP in 1946 and spent a year as an assistant in a Dunfermline general practice, before completing the diploma in public health in 1948. After four years as an occupational health physician in Glasgow, he moved in 1952 to Aberdeen University as a lecturer and then reader in public health and social medicine, completing both an MD and a PhD on the health of men in heavy industry. There he was soon taking a lead in the education of medical students and in developing student attachments to general practices, as part of his vision of community based teaching of the subjects of public health and social medicine.
In 1966, when the university acquired funding from the Nuffield Provincial Hospitals Trust to create a general practice teaching unit, Ian Richardson was one of an extensive field of applicants, the majority of whom were senior north east general practitioners without academic experience. He was appointed reader, a decision which raised eyebrows among many locally who had wanted a “real” general practitioner to lead the new initiative. However, Ian quickly engaged the general practice community with his belief in the need to define and measure the job of being a general practitioner, and found a valuable role in a sessional attachment to the Portlethen practice, where he quickly developed a cadre of loyal patients.
At the time of his appointment, all the embryo UK departments of general practice had been built round working general practices and were largely—but inadequately—funded by their NHS income. Their heavy clinical demands made research difficult to develop, and their academic standing in their medical schools was tenuous. Ian Richardson was determined to promote a different model and insisted on all posts being fully university funded, with the clinical roles of new staff defined in a way which left adequate academic opportunities. This fitted the local general practice scene well, as Aberdeen was well endowed with general practitioners and new competition for patients would not have been welcomed.
He became the first professor of general practice at Aberdeen in 1970 and soon built a small but effective team of full-time lecturers from outside the area, supported by a team of part-time lecturers based in north east practices. His own work centred on developing a health centre strategy for the city of Aberdeen, which in due course led to the creation of the Foresterhill Health Centre within the teaching hospital campus. It housed three working general practices, the university department of general practice, and some community services. He worked with some 150 local doctors (a majority of those in the area) to produce the north east Scotland workload study, which proved a fertile source of data for descriptive studies over the next decade. With his colleague Ian Buchan, he carried out a time study of general practice consultations, promoting the idea of 10 minute consultation ahead of its time. Always a supporter of the general practice team, he later repeated the format with studies on the work of district nurses and health visitors. Meanwhile, after much local negotiation, he created a 12-place vocational training scheme based on Aberdeen Royal Infirmary including imaginative posts. This new scheme combined the so called minor specialties with a half-day release course running throughout the three years, incorporating a Balint-type experience during each teaching session.
Ian Richardson was greatly influenced by the teaching of Michael Balint and the work of the London Teacher’s Workshop which it had inspired. He made connections with influential thinkers in the Royal College of General Practitioners and became involved in its undergraduate education committee and with the developing MRCGP examination, bringing his clear thinking and rigour to the development of the MCQ and later chairing the board of examiners. His eminent academic contributions were recognised by the royal college with the award of the 1981 William Pickles lecture: “Verities yet in their chaos,” which he described as the “supreme moment in my professional life.”1
In the same year, he became dean of the Faculty of Medicine in Aberdeen. He was the first professor of general practice in the UK to hold such an office. He would have been a distinguished dean during times of growth, with his breadth of vision about how medical education was developing. However, his deanship coincided with three years of significant “volume cuts” in university funding, with a national hiatus in policy development in its wake. The senior staff in his department were promoted elsewhere, two to chairs, and their posts frozen; Ian himself retired in 1984, and his chair was also suspended (until re-established in 1992).
He brought to academic general practice one of the most acute and analytic intellects of his day. He wrote his lectures and talks in pencil with meticulous attention to detail. He championed research which developed theory, as well as having practical interest. He was devoted to the wellbeing of students, nurturing young talent and promoting interdisciplinary thinking and working. His championing of a structure of departments of general practice primarily based on university as against NHS funding was forward looking, and is now the most widely accepted model. He retired to Auchterarder, working with the local practice as a summariser of records, keeping his skills as a painstaking record keeper in the service of the local community.
Ian Richardson was devoted to his family and kept his professional and family life quite separate. He and his wife, Mary, were exceptional hosts, holding numerous social gatherings, typified by their warm generosity. He was an avid rose gardener, in the company of his beloved labradors. A justice of the peace, he was committed to the work of the Juvenile Court. At one time a church elder, he was later a humanist. Not surprisingly he was a meticulously straight player on the golf course; but, perhaps unexpectedly, sports cars and a Rolls Royce were his other passion.
His legacy is in the careers of countless people who were inspired by his thoughtfulness, his wise counsel, and his warm friendship over a long, a varied, and an influential academic life. Predeceased by his wife, Mary, he leaves two daughters, one a general practitioner, and five grandchildren.
Cite this as: BMJ 2011;342:d2679
Former inaugural James Mackenzie professor of general practice University of Aberdeen (b 3 March 1922; q Edinburgh 1944; MRCP, DPH, MD, PhD), d 16 December 2010.