TY - JOUR T1 - Family practice: meanings for modern times JF - British Journal of General Practice JO - Br J Gen Pract SP - 207 LP - 212 DO - 10.3399/bjgp10X483571 VL - 60 IS - 572 AU - Amanda Howe Y1 - 2010/03/01 UR - http://bjgp.org/content/60/572/207.abstract N2 - The words ‘family doctor’ and ‘family practice’ are common in the language of GPs,1 and ‘family medicine’ denotes a claim to medical speciality status in many countries where it remains possible to practise without a postgraduate qualification.2 Yet the image of family practice as manifest by William Pickles, the foundation President of the RCGP, appears both impractical and paternalistic from a 21st century perspective. The critical question raised in this lecture is whether family practice still has a unique significance at this stage of the development of medicine as a profession, and if so, what characterises this speciality, and how its principles can be passed on to future family practitioners. It concludes that the principles of family practice lie in the psychological aspects of doctor–patient interactions, and that the principles of sustaining therapeutic relationships need to be core to rigorous training and practice.The archives* of William Pickles' personal and professional papers reveal him as a ‘family man’: his marriage was long and happy, and he knew each of his patients intimately. He was, in Aysgarth, a ‘father figure’, who was consistently committed to the community he served for many years, and who went the extra mile to help them; something that we would normally associate with kith and kin. He himself was one of a large family: the son of a GP, one of six boys, five of whom were GPs, and the sixth wished to be. It can be assumed from this that there must have been a strong family identity around that shared career. His mother was a positive influence on his attitudes, he writes that she: ‘… strove off an insufficient income to feed and clothe us and was in many ways a remarkable woman. I remember her as an advocate for old … ER -