Chris Lancelot: History suggests GPs could be more open-minded

This year is the 40th anniversary of the founding of St. Ann's Hospice in Heald Green, Greater Manchester.

The GP Record, by Fran Orford www.francartoons.com
The GP Record, by Fran Orford www.francartoons.com

As well as being a cause for commemoration it is also a reminder that our profession is considerably less open-minded than we like to think.

The hospice movement has had to fight for its principles against a medical profession which thought it had little to offer. St Ann's was only the third hospice in the UK: it took 20 years before terminal care gained general acceptance as a speciality within the profession. But look at it now. I can't imagine there is a single doctor anywhere who doesn't value what the hospice movement provides. Indeed, it now seems crazy that any clinician should ever have raised any objections at all.

The hospice movement isn't the only development that has faced indifference or downright opposition from the medical profession. To our shame, we have collectively resisted some of the most important developments in healthcare.

Fifty years ago, any doctor referring a patient to an osteopath could be struck off. Food allergies were a figment of complementary therapists' fevered imagination. More recently, Helicobacter pylori had nothing to do with the causation of stomach ulcers. Oh yes, and we opposed the introduction of the NHS.

What is the connection between all of these and their rejection by the medical establishment of the time? Could it be that We Didn't Think Of It First?

Yet, during the same period, many developments which the profession initially welcomed later proved problematic - Eraldin, Opren and Thalidomide; operations for 'floating kidneys'; three weeks of complete bed-rest after MI; the ban on beta-blockers in heart failure ...

As a profession we are not as correct nor as open-minded as we might think. In the worst cases we are arrogant, self-satisfied and pig-headed, convinced that our way alone is right. We like to think of ourselves as 'scientific', 'objective', 'unbiased' and 'right': history suggests otherwise.

We now know that 20 per cent of medical knowledge changes every five years. By 2030, how many of our current, firmly-held beliefs will seem narrow-minded, counter-productive - or just plain dangerous?

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