The flip-side is the rise of patient empowerment and demise of paternalism which is known to have adverse effects on patient's health, whilst enablement can improve outcomes of health. The potential vulnerability of patients was most dramatically exposed by the frankly pathological behaviour of Shipman, although he was a unique exception. The power and authority accorded to GPs has also been questioned with a series of flagrant abuses of professional autonomy receiving extensive media coverage. The fictional image of Dr Finlay belies the reality of five minute consultations, often delivered in public as the GP rotated around the waiting room, prescription pad in hand. It was not uncommon for GPs to reach retirement in poor health and with dysfunctional family relationships. Practising in this manner demanded a selflessness which offered quality care for patients but which exacted a toll on the doctor's quality of life both physically and emotionally. The traditional view of general practice, personified in John Fry, is of a GP following patients from cradle to grave with continuity of care as the norm. By remaining grounded in the reality of seeing patients, the theory they espoused remained rooted in practice and as such they might be seen as knowledge brokers 2 in today's terms. Pickles, as a primary care epidemiologist, was a similar seminal figure in contributing to the scientific basis of general practice. Through his rigorous collection of data and analysis of daily practice he captured what was both familiar but, at that time, undocumented. Undoubtedly, Fry's greatest contribution has been his systematic approach to general practice, which in turn has contributed to its evolution as a discipline. However, for all the changes witnessed, much of the heart of general practice remains the same. It is likely that were John Fry to visit the contemporary world of general practice he too would be taken aback by the transformed context in which we care for patients and the different frameworks within which we work. When Aldous Huxley first described his vision of a ‘brave new world’ 1 few of his readers would have recognized the chilling society he presented.
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