But, it is recent policies that threaten to bring the biggest change to general practice. APMS, polyclinics and the DoH's insistence on the introduction of 'the market' and private providers could drastically alter the face of the profession.
Many practices are so concerned about these issues that it is difficult to plan for the long term. Some fear they may be forced into polyclinics, while others are worried about contracts private providers are winning in their area. This, coupled with the fact that 90 per cent of practices are unclear about future income levels because of the end of the MPIG, makes for uncertain times.
Because of this uncertainty practices are more reluctant to offer partnerships. Figures from earlier this year show that the number of partners in England fell from 29,340 in 2005 to 27,342 in 2007 (GP, 25 April).
Partnership opportunities for new and younger GPs are thin on the ground, which means the majority will start out as salaried employees, but there are also fewer salaried posts available in traditional practices.
In 2006, GP conducted a survey among a group of 'GPs to be'. More than half said that they would not work for a private provider under any circumstances.
Fast forward two years and the results are very different. Today, only 36 per cent said that they definitely would not work in a private company 52 - per cent said that they would.
In most cases, this is not because they want to work for private providers; it is because there is little other choice. Most of these new GPs want to become a partner, but a job is a job and their main priority is to use their training and practise as a GP.
The problems this causes are two-fold. Firstly, you have a group of disaffected young doctors who feel that the career they expected has not materialised and that they are not afforded the chances previous generations of GPs have enjoyed.
Secondly, without more partnerships there is a distinct possibility that working for private providers and polyclinics will become part of the 'normal' GP career path and, in the long run, this could strengthen the hand of these organisations. Taken together these two factors weaken the profession.
To ensure the current model of general practice continues, it is vital that there are more partnership opportunities.
The responsibility for this lies with current partners. If existing partners want to secure the profession's future and guarantee traditional general practice remains at the heart of the UK's health system they must invest in the next generation.