ABSTRACT
During the early 1950s a series of investigations took place into the state of general practice in Britain. In 1950 Joseph Collings, a Research Fellow from Harvard, produced a highly critical report which caused a considerable stir when it was published in The Lancet. His findings led the British Medical Association (BMA) and the Nuffield Foundation to organise their own inquiries which resulted in the report of Stephen Hadfield, published in the British Medical Journal (BMJ) in 1953, and Stephen Taylor’s book Good general practice, which appeared a year later.1 These reports mainly concentrated on the organisation and running of practices, on the physical conditions under which medicine was practised, and on the level of service offered to the patient. However, little or no attention was given to the effect that the personality of the individual doctor could have on the health and welfare of patients. It could not be said that this element of general practice went unrecognised by contemporaries. Collings himself wrote that general practice was:
a unique social phenomenon. The general practitioner enjoys more prestige and wields more power than any other citizen, unless it be the judge on the bench. In a world of ever-increasing management, the powers of senior managers are petty compared with the powers of the doctor to influence the physical, psychological, and the economic destiny of other people.2
