ABSTRACT
In the varied topography of professional practice, there is a high, hard ground overlooking a swamp. In professional practice, applied science and research-based technique occupy a critically important but limited territory, bounded on all sides by artistry. This artistry is concerned with framing problems and implementing solutions. The professional regulation of doctors is only one element of quality assurance in the National Health Service. Individual clinicians work as members of both clinical teams and of larger organisations. The possession of expert knowledge and skill has always been one of the defining characteristics of membership of a profession, but there has long been debate about the nature of this knowledge and its relationship to skilled practice. The codified knowledge of medicine is readily available to patients. The proposition that medical practice is founded on ‘personal’ knowledge does not fit well with the scientific problem-solving model, but may reflect reality.
