ABSTRACT
Husband-wife (frequently doctor-nurse) or family 'teams', very much part of the lore and history of general practice, have all but disappeared from contemporary medicine. This is a consequence of diverse social changes that range from doctors now marrying doctors (rather than nurses) to the emergence of the 'new' patient, and of patients' rights. Relevant, too, are changes in patterns of care that relate not only to developments in medicine, but also, by the 1970s or so, to social changes, such as improved transport in far-flung rural areas. As one Canadian general practitioner noted in 1989: 'I think the greatest change in medicine on these islands [in rural Newfoundland] is that no longer do we feel self-sufficient, that we should do everything the patient needs ... We refer our patients to other specialists, to tertiary centres where the high-intensity medical care is given.'2
