© The Society for the Social History of Medicine 2005, all right reserved
A Professional Myth: Personal Continuity of Care and New Zealand General Practice in the Twentieth Century
*Academic Unit of General Practice and Community Health, Medical School of ANU, The Australian National University, Canberra, ACT 0200, Australia. E-mail: marjan.kljakovic{at}anu.edu.au
Department of History, Victoria University of Wellington, PO Box 600, Wellington, New Zealand. E-mail: melanie.nolan{at}vuw.ac.nz
In this article, we question the narrative of a ‘diminishing class’ of family physicians providing continuity of care. A case-study of general practitioners in Wellington, New Zealand, suggests that there has been less change than many believe. We seek to establish that treatment by traditional family doctors constituted a minority experience. Alternative accounts tend to focus on continuous practices but these probably represent just over a third of the total. Despite this fact, there is a widely held contemporary perception of debased primary care provision. Indeed, general practitioners themselves have contributed to the development of the myth of a twentieth-century demise of continuity of care, and particularly so during the 1960s and 1970s when many were seeking to establish a role as primary providers. Ironically, the myth of the demise of the traditional family doctor has made general practitioners, and many patients, even more discontented with contemporary services than should perhaps be the case.
Keywords: general practice; continuity of care; transience; persistence; professional myth; general practice medical training
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16 Report of the Special Committee on the Availability and Distribution of Medical Practitioners, 1959–63 (Wellington, 1964) cited similar figures.
17 North, ‘Immigration and Emigration of New Zealand Doctors’.
20 Geiringer, If Doctors Grew on Trees.
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35 Medical Council of New Zealand, Medical Manpower in New Zealand, pp. 42–3.
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61 There are also a number of general studies: R. Fulton, Medical Practice in Otago and Southland in the Early Days (Dunedin, 1922); Wright-St Clair, A History of the New Zealand Medical Association.
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64 Belgrave, ‘"Medical Men" and "Lady Doctors"’, ch. 7, pp. 241–85.
65 The Royal College of General Practitioners funded a summer studentship for a cross-disciplinary historical study of GPs in Wellington, from November 2001 to February 2002. R. Swindells was employed as a summer student and her work was supervised by M. Kljakovic, Wellington School of Medicine, University of Otago, and M. Nolan, History, Victoria University of Wellington.
66 New Zealand Government, A Health Service for New Zealand; W. Stephen, An Analysis of Primary Medical Care. An International Study (Cambridge, 1979), p. 285.
67 This accords closely with the Department of Health data which stated that 17.3% of active GPs in Wellington had been qualified for more than 30 years, ‘Table V. Urban Areas: Active GPs more than 30 years qualified’, in A. Thompson, Where Should I Practise? The Distribution of Private Medical Practitioners in New Zealand, 1967 (Wellington, 1967), p. 65.
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