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Alistair Hay describes his vision as one which would have enthused him as a newly qualified GP. I'm afraid I must disagree - he has sketched out what seems to me to be a vision of hell. I trained as a GP in order to care for the whole person; what Hay is suggesting here is a fragmented and taskified model, where each episode of illness is treated as discrete and separate. I think this model will lead to inefficient care, where patients return multiple times for care which could be much more effectively delivered by a single GP engaging with the whole person. GPs get to know their patients through the delivery of routine care, so that when complex problems arise they have a trusted clinician who knows them well. I didn't train to be a GP to orchestrate a team; the joy of general practice is in the relationship with the patient, developed over years. I worry that we are training a cohort of GPs who have never experienced this. All the evidence is that it is relational continuity with individual GPs that delivers benefits; there is no evidence at all that team based approaches can substitute for this. I think that this vision of how general practice should work could actually destroy the profession.
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British Journal of General Practice
