What's wrong in this scenario* is that Dr Zen's practice has been hijacked by guidelines, economic imperatives and intrusive technologies. Evidence-based medicine may be a comfort to Zen in the five minutes she has and may improve the look of the annual report of Corporation Enterprise, but the value of her skilled interpretation of the patient's narrative has been ignored. She remains a world away from her patient, with little time to weigh and integrate the research evidence on her screen. Algorithms and hospital-based trials cannot care compassionately for a man grieving for his lost wife, but narrative-based research may provide guidance.

In Corporation Enterprise, the role of team care and the balance between managers and clinicians have been lost. Managers have implemented research-based reforms focused on efficiency, with little regard for the clinical needs of patients.1 In this context, the relationship between Ease and Corporation Enterprise is dangerously ill-directed and reduces the credibility of Ease's research.

General practitioners are naturalists by training, spending many hours each day observing and summarising the multiple encounters they have with patients. Research that is not patient focused will simply entrench the cultural divide between researchers and practitioners. Dr Zen needs to reintegrate clinical research using observational data into her practice, and this can only happen if Corporation Enterprise revalues such research. To balance her own experience, Zen needs evidence on the natural history of the diverse presentations she encounters and on the use of diagnostic tests, therapies, and screening and prevention activities.2 For this evidence to be relevant to Zen, it has to be generated by networks of GP researchers using appropriate information technology.3 Narrative research is also needed, where the patient's story, including where they live and work, their family, culture, and past health experiences, can form the subject of enquiry.4 By its very nature, such research requires the active involvement of GPs like Zen, and it must value their story as part of the final result, just as it values evidence of patient empowerment and preferences,5 as well as the more conventional morbidity and mortality measures.

We see that GPs will embrace the world of relevant research, given time, support and leadership. Establishing networks of research practices across Australia with strong and positive relationships with key academic centres and GP divisions is a priority. These research groups need to be cross-disciplinary and embrace multiple methods to answer the complex everyday problems that present in general practice. They must train their members to ask focused and answerable questions. Protected (funded) time is vital for those GPs who want to spend time answering these questions. Three- to five-year career paths for new researchers and passionate visionary mentors are other important elements. Above all, we need GPs to constantly question what they do in everyday practice and feed these queries into these research networks. Clinically important studies will follow. How to manage tiredness in a 55-year-old man, night sweats in a 17-year-old teenager and headache in a 10-year-old girl are some of the everyday priorities facing Zen and all practising GPs for which there is no evidence.

What will the future look like? We hope — with some justification — for something better than Dr Zen's nightmare.

2020 is a good year for general practice research. All 20 established GP research groups, in collaboration with other primary care organisations and consumer groups scattered across Australia, have secured large National Health and Medical Research Council grants, many being cross-disciplinary. Five of the projects from these groups have just won awards for "excellence in societal impact". These new awards were established in 2010 for projects judged most likely to improve the quality of care provided to the community. Twenty new GP and primary care fellowships of five years' duration have been secured. Corporation Enterprise has just announced the extension of a Professorial General Practice position in Primary Care Leadership and Practice-Based Research.

Dr Zen has just logged on to the Professor's website and found new information from research programs on back pain in young men, headache in teenagers and the role of exercise in patients with rheumatoid arthritis. She downloads a new decision support algorithm for the management of tiredness. She emails the professor's personal assistant about a new question she has concerning the palliative care management for her patient in heart failure, and receives a return invitation to apply for funding for protected time to explore the research potential of this question. She takes a taxi home with a smile on her face as she contemplates how to fit this new opportunity into her working life.