Lessons from Mackenzie that still resonate

Abstract

On 4 June 1921 Sir James Mackenzie defended his thesis, The Opportunities of the General Practitioner are Essential for the Investigation of Disease and the Progress of Medicine , in the British Medical Journal . Just under a century later, there is still a message for all researchers in primary care which resonates. A short precis of a full commentary from the International Journal of Epidemiology is given below.1 Sir James Mackenzie (1852–1925) is known as ‘the father of general practice-based research’.2 From humble origins in rural Perthshire, Mackenzie overcame early social and educational hurdles to study medicine in Edinburgh, then pursued a career in general practice in Burnley. He initiated the systematic observation of his patients that led to his stellar research career, including an international reputation in cardiology, discovery of novel and important insights into heart rhythms, the use of digitalis, and a knighthood. At the height of his career in London, he returned to establish the Institute for Clinical Research in St Andrews at the age of 64. It was there that Mackenzie brought together all the GPs working in the town, and encouraged the systematic recording of routine observations and the development of record-keeping systems. By working with local colleagues in primary care, he made his real key insight: that systematic observation and recording of symptoms and signs in a whole population could provide essential information on the epidemiology, prognosis, and mechanisms …