There is no doubt that the general practitioner's job description has changed over the years, and the argument about what doctors who work beyond the hospital gate actually do for their daily crust fills many a column. As a callow youth, when I started in the discipline, the norm was for the doctor to do just about everything, from suturing minor wounds to amateur midwifery in the middle of the night. Over the years, however, our core job has changed not because of because of new duties that we have acquired, but because of what we have given away. Midwives deliver the babies—increasingly it seems, in wetsuits; casualty workers sew up the lacerations, health visitors do the vaccinations, CPNs (community psychiatric nurses) follow up the seriously mentally ill, and counsellors and psychologists attend to the rest. Community paediatricians sally out from their hospital clinics; there are liaison nurses for diabetics and Macmillan nurses for the terminals; school nurses have graduated from nits to postcoital contraception, and the practice nurse now seems to do chronic disease management. We have finally …