ABSTRACT
The primary care reforms since the 1980s are a symptom of global economic and political change. Being a mature general practitioner requires the replacement of an exclusive and over-idealised medical role with an integrated role set that includes patient care, staff management, and political liaison with the system. To accomplish the implicit adaptation in professional identity, the needs of the doctor must be put alongside the demands of the patient and the system. In the primary care context, transitions have become a way of life and members of primary care organisations are caught between the known and the unknown in such a way that they fear the loss of their roles and security. Professionals, being used to vocational self-regulation, begin to resist change when it is ordered and planned from above and without cognisance of the evolutionary nature of work and its social organisation.
