On page 356, John Gillies and colleagues describe a learning journey undertaken by RCGP Scotland in an attempt to define the essence of general practice.1 The context is the hostile intellectual environment perhaps best illustrated by Tony Delamothe's distressingly narrow and politically gullible article, published in the BMJ in November of last year.2 Clearly captivated by his own clever title, A good QOFfing whine, Delamothe, in his role as the Journal's Deputy Editor, is intent on dismissing the immeasurable and the ineffable from the discourse and analysis of medical care: ‘In the current financial and political climate is it wise to defend primary care solely by invoking its warm fuzzy heart, beating away in its black box, far from the close scrutiny of all but its adepts?’
The problem is that the warm fuzzy heart is the essence — that by which it is what it is. Delamothe implies that there have been no attempts to explain the black box of general practice other than to an inner circle but this is simply not true. The paper by Gillies and colleagues is the latest of many worthwhile attempts to open up the black box to scrutiny. The key is that a thorough grasp of the science of medicine is essential but insufficient for the care of patients in general practice. …