Book review: Joseph's Box

Abstract

Essay already in place and the pace of further change currently occurring it is hard to turn the clock back, nor indeed might it be appropriate on health, economic, or current political grounds to even try. So it seems to me that English general practice had a good and worthwhile life which is now ending. At the end of my time in the UK both my parents died. They too had good, long, and worthwhile lives but the quality of life in their last few months was not good. Such rationalisations do not seem to make the loss any easier to bear though. My father died 8 days after my mother-I had not come to terms with the loss of one parent before I had lost another. For now, I have returned to a style of general practice in rural Australia that, by chance, COMMENTARY 'Don't worry about the world coming to an end today. It's already tomorrow in Australia'. Charles M. Schulz US cartoonist (1922-2000). 'A final g'day to general practice' is a poignant and thought-provoking commentary on modern general practice. 1 As a young GP myself, I see disillusionment among my peers. The emerging two-tier system and a sense of 'tick-box medicine' create dissatisfaction among new and old doctors alike. It is little wonder that many young doctors are following the author's lead and emigrating to Oz. Interesting too are the comments on communication with our hospital colleagues. Last week I met a paediatric oncologist who reminisced mournfully about GPs phoning for 'a bit of advice' and expressed a real enthusiasm for more human contact. Choose and Book has yet to reach Scotland but clearly it may widen the communication gap further. Despite this, general practice remains, I think, a highly rewarding job with much hope and promise for the future. The RCGP publication The Future Direction of General Practice states that 'The generalist who can provide holistic and patient-centred care is needed now more than ever'. 2 Perhaps then it is not time to mourn for the loss of general practice but rather to fight to keep it alive. With the words of Thomas Jefferson, 'A little rebellion now and then ... is a medicine necessary for the sound health of government'.