[General practice adrift. Explosion of knowledge, technological development and population]

The explosion of biomedical research, and in turn, the far-reaching specialisation, which accompanies it, makes the health service field increasingly obscure and confusing. The general practitioner as gatekeeper occupies a central and much needed role in health care. Inherent this role are the professional core qualities of continuity, entirety, and a personal doctor-patient relationship, which ideally allow the GP to sort out and co-ordinate available services so that they suit the individual patient. These GP qualities also have the merit of making patients more content, they contribute to shared decision making, and they limit costs through more co-ordinated services. General practice today is faced with a dilemma. Increasing specialisation, consumerism, and liberalizsation threaten to eliminate the generalist role in health care, precisely at a time when it is most acutely needed.