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To the Editor: The Journal’s recent, extremely interesting issue on general practice (7 July 2003) has prompted me to look back at a symposium held at Sydney Hospital on 1 April 1966 (April Fools Day!). The subject was “The future of medicine”. The three speakers were Sir Charles McDonald, Chancellor of the University of Sydney; Mr Harry Jago, NSW Minister for Health; and myself, on behalf of the Australian Medical Association (NSW). My contribution on that day concluded as follows:1
From the facts, figures and trends which I have given you, I would forecast as follows (and again, this must be subject to no radical changes in the international, political or economic framework of the country).
There will be a relative decrease in the numbers of doctors available to the community, and the greatest fall will be in the group most needed, the general practitioners. On the other hand, I expect a greater demand by the population for medical services. The average age of the patients will slowly increase, and geriatric problems will make up the bulk of day-to-day medical problems. It is likely that universities will have different types of medical training for those who plan to undertake general practice and those who intend to specialise.
The State and other third parties will provide the main channel by which medical practitioners are remunerated, and I hope (but by no means feel certain) that most will be remunerated on a fee-for-service basis.
Small country towns will have even less resident medical attention than they command at present, but better transportation and communications will enable them to be serviced from the large towns with base hospitals.
In the hospitals, increasing use will be made of full-time and part-time paid specialists, and in addition new hospitals will arise in the form of geriatric hospitals and hospitals staffed by general practitioners.
Finally, the social, financial and professional status of the medical practitioner will ultimately depend on professional unity and wise leadership. Loss of status will inevitably occur with breakdown of either of these conditions.
Perhaps I should have been a fortune teller!
©The Medical Journal of Australia 2003 www.mja.com.au ISSN: 0025-729X
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