One important change in general practice in the past 15 years has been the emergence of the concept. There are many different interpretations of what this phrase means, whether the idea works, how it should be organised, and so on, but virtually all our patients now come into contact with a variety of people with different training and different skills. These are usually organised into two groups: a community health care team of health visitors, community nurses, nursing assistants, and midwives; and a surgery team of receptionists, secretaries, perhaps a practice manager, treatment-room nurses, and sometimes other skilled workers. The divisions are not quite as hard and fast as this implies, and there are considerable variations in the patterns of employment and work. There is about one whole-time equivalent worker in each group per doctor, but as most doctors work in groups and most workers are less than full time each doctor and his patients have to relate to four or five people. This often produces problems of communication and continuity of care, which are compounded by great variations in training and skills. Overcoming these diffi? culties is an important part of organising a good practice and has a direct bearing on the quality of care provided to patients. It is an anachronism that the front line in general practice is manned by the least trained troops, causing it to become an area that generates the most dissatisfaction from patients. Rudolf Klein1 has shown that at least a third of all grumbles about us arise for this reason, and Ann Cartwright and Roben Anderson' have shown that between 1964 and 1977 we did not get much bener in the way we handle these things. It is a truism that no matter how brilliant we are at diagnosing esoteric conditions if the patient cannot reach the doctor through the system then all is Training