The Australian College of General Practitioners
Annals of General practice. V. 10( 2) June 1965
JUNE, 1965 ANNUAL GENERAL MEETING
ACADEMIC SESSION, OF THE AUSTRALIAN COLLEGE
OF GENERAL PRACTITIONERS, AT WILSON HALL,
UNIVERSITY OF MELBOURNE
ADMISSION OF SIR ROBERT MENZIES AS AN HONORARY
FELLOW OF THE COLLEGE 9th October, 1964.
Speech by the Prime Minister, the Rt. Hon. Sir Robert Menzies
Your Excellency and Sir:
This show3 how wrong one may be, because I came here tonight
saying to myself, ' His Excellency the Governor will make a speech and
I'll be able to pick up a crumb or two, and then my old friend, Sir
Victor Coppleson, he will speak'. Not he, silent as the tomb, and
therefore all that is left for me to do is to say thank you very much,
Sir. I appreciate this honour, and in a strange, odd fashion, you
know, I have rather earned it. Would you mind if I developed that
theory a little?
As you know, in the course of a life of a man like me, one
acquires certain things by merit and other things by favour. I managed
to get a degree or two in this university by working for them
and in later years I have been given a series of unearned honours
which give me the most immense satisfaction. For example, I am a
surgeon. Never let anybody entrust himself to my scalpel, but I am
still a surgeon. Whenever my general practitioner looks at me, or even
my expert specialist consultant who is going to make a speech tonight,
I like to remind them that I am a surgeon and I am also a physician,
and also, you don't think I am boasting-this is a simple narrative of
fact-I am a gynaecologist and obstetrician, though whether as a
patient or a practitioner has never been made quite clear. I seem to
remember that I am an architect, but not responsible for everything you
see. I am a builder, I am an scientist. This is a boasting record, but
I mention it to you firstly to say I didn't earn any of them and, secondly
ANNALS OF GENERAL PRACTICE
to make you understand after all these events that I am now so
superbly qualified to become a general practitioner.
Now, Sir, I have been lucky enough in my life not to encounter
professionally the medical profession too much. I used to have a bit
of fun in a clean way at the bar in my time, cross-examining doctors,
who are very easy to cross-examine, much easier than when you are
their patient, and I haven't been their patient all that much, but I
have lived long enough to have the most tremendous regard for what
goes on in the medical world and I have lived long enough to have
a particular regard for the work done by the general practitioner,
because the general practitioner, as His Excellency said, he is the family
doctor, he is the man you know, he is the man who knows you, knows
the family, who can speak intimately and yet with authority and he is
the rman who, over a long period of time, has been the first diagnostician
when he comes to handle something in the family or in the family
circle. I find it hard to believe, Mr. Chancellor, when I look back on my
time here and on your time here when we who were students of the
law certainly understood that we were much more intelligent than
the medical students, I find it hard to believe how many of these
scamps who were medical students in my time have now become the
most trusted family advisers. And they have, and that proves, of
cour:; e, that it is a jolly good thing to get it out of your system at some
time or another, because I venture to say that there are more
millions of people in Australia who owe a debt to the family doctor
than there are any corresponding number who owe a debt to any other
particular group in the community.
I have been exercised, as I know you have in this College, exercised
about what is going to happen in the future, because in my own
lifetime, which goes back before the turn of the century, all sorts of
astonishing things have happened in the medical world. I have no
doubt that at the time when I was born, the true function of a physician
was to keep his patient quiet and allow nature to take its course.
I have no doubt that not long before I was born and before all the
subtleties of anaesthesia were being got to be understood, surgery was
a chancy thing; in fact, it is only in the memory of some men still
living that antiseptic surgery gave place to aseptic surgery.
It is really an astonishing thing for somebody like me to realise
that in his own lifetime the greatest discoveries affecting mankind
have not been in the field of destruction as some people think, but in
the field of preserving life as more people ought to think. Because
of all these things, the work of the biochemists, the work of the
microbiologists, the extraordinary developments of drugs and techniques
in the specialised fields, it must become increasingly difficult
for a general practitioner whose day begins at any hour of the early
hours of the morning and whose day ends at about the same time.
It must be difficult for him to feel that his tremendous job of dealing
JUNE, 1965
with people in the broad and dealing with people in the particular
has to be performed against a background of knowledge with which
he must feel, occasionally, he is losing touch.
Now this is a problem I think that I, as an outsider, understand,
Do we want general practitioners merely for an instrument for passing
patients on to great specialised experts? I hope not. Or do we want
the trusted family doctor, skilled in understanding, skilled in diagnosis,
to preserve his position by keeping up, in the broad and in the particular,
his knowledge of the new developments in medicine, so there
is not an unbridgeable gulf between what he knows he understands
and what he knows is understood by the most refined specialists in
the medical and surgical world? If I were a family practitioner this is
what I would want to feel. Yes, of course, there are great specialised
experts who know more than I do in their particular field; they ought
to, because I have to cover, at the beginning at least, all fields. But
I do want to believe that every year I know more and more about the
new discoveries, that I am every year becoming competent to understand
these latest developments and to know what it is that my highly
qualified specialist will be talking about.
This is tremendously true. We are not having a great gulf between
the specialist and the general practitioner, because if we do, the
general practitioner will begin to feel more and more that he merely
begins something and that the skill, the expertise, must belong to
other people. If I were a specialist in some branch of medicine, I
would want to know that general practitioners every year knew more
and more about the kind of thing that I was concerned with, and
I am sure that the general practitioners would want that too.
That means, as I understand it, the reason that this College.
has been established-I heard about this before it was established.
My own family doctor used to address me very earnestly on. this sub-.
ject when he had me at what you understand to be a disadvantage,
and even from the beginning, I can see quite clearly that a College
of General Practitioners, which is going to include within its scope
educational work, refresher courses, lectures and practice in matters
which are new, is going to do something even more tremendous for
the whole body of medical knowledge and of practice, and so Sir,
surgeon though I may be, I think this is one of the great moments of
my life. I have been a general practitioner in other fields for a long
time. It is a very great honour to become a general practitioner
in the field of medicine.
ANNALS OF GENERAL PRACTICE
A SURVEY OF ACUTE RESPIRATORY ILLNESS
by ALAN H. B. CHANCELLOR, Metrylands, N. S. W.
Acute inflammations of the respiratory passages are very common
ailments in the general population. The cause of these disorders is
uncerlin and although surveys have been conducted on many groups
there has been little study made of such unselected patients as voluntarily
consult a general practitioner. An attempt has therefore been
made to isolate viruses and bacteria from all patients seeking treatment
for symptoms of up to seven days duration, referable to the respiratory
system. The Institute of Clinical Pathology and Medical Research at Lidcombe
N. S. W. has co-operated willingly in doing this laboratory work.
Patients were studied during two periods, from 4th November,
1963 to 20th December, 1963 and from 2nd May, 1964 to 4th
August, 1964. The study was carried out by one member of a group
of seven general practitioners and the patients were the only ones
to exercise a choice of which doctor they would see, apart from
ccout of hours" periods. Type of Disorder
( f the 218 patients studied, 2 were suffering from bronchitis
and 19 had a wheeze without any other evidence of bronchitis. The
remainder had upper respiratory signs only.
Age distribution
The age distribution of the studied group and the observer's
patients in general ( calculated from the ages of 2147 different patients
seeking treatment between November 1963 and June 1964) is shown
in Table I. Table 1.
Age distribution of patients. Shown as of total of each group.
Age in years 0-9 10-19 ' 20-29 30-39 40-49 50-59 60-69 70
Studie:; Group 50 14.6 11 7.8 8.7 3.2 3.7 1
General Patients 21 15 11 13 16 11 17 6
Collections
Samples were taken in the consulting rooms or in the patients'
homes. A swab for bacteriological examination was placed in either
a glas; s tube or a plastic envelope and then a throat gargle was obtained
and returned to a McCartney bottle. These two samples were placed
immediately in a refrigerator or into a vacuum flask with ice and stored
thus until delivered to the laboratory. Patients who were unable to
garglie had a second swab taken which was then broken off into a tube
of transport fluid and shaken before being placed on ice.