. . . The general practitioner of 50 years ago sat in his street corner surgery in secluded dignity and charged his fees according to his judgement, his conscience, or his patient’s ability to pay. His successor today is presented with a book of charges which divides the practice of medicine into more than 8,000 “items”, with references and cross references and definitions of charges according to length in centimetres, depth, anatomical regions and boundaries. Medical historians of the future will have an easy time to prove the decadent barbarism of this humanistic profession in the second half of the 20th century.

Medical practice in general, and the traditional general practice in particular, is doomed unless it decides to accept the challenge and adapts itself to changing demands of the present and the foreseeable changes of the future. . . .

The average Australian looks at the medical profession with a hesitant reserved blink, and accepts the fact that every time the doctors hit the headlines there is an increase in fees. General practitioners should at least take the initiative to give the oncoming generation of doctors an adequate training which they so sadly missed themselves, and mobilize public opinion in support of their plan for a better, more up-to-date medical and health service.

It is up to the Australian general practitioner to accept this responsibility, and to prove that he is committed to provide such a service before his patronizing peers manipulate him into a state of professional sterility or extinction.

Present failure and future commitments of general practice
A Deery, MJA 1971; I:1191-1195

Sir: Re your leader of January 5, the general practitioner is heartily sick of the many platitudes uttered about his glory. Gradually, with the establishment of baby, pre-maternity, T.B., venereal, asthma, diabetic, rheumatism, and other clinics, his work has been filched from him and gradually his income has fallen. The very hospitals which train him are his leading competitors; and where will it end and what use all this extensive training? Why should we keep up to date in diseases we never see? It can lead to only one way: the degeneration of the general practitioner. His income will ultimately fall so much that he will be obliged to take a government job and many will lose interest in their profession. It behoves the powers that be to seriously consider these things before it is too late.

Yours, etc.,
Leslie Larbalestier
MJA 1935; I:192 [letter]