<<The RCGP is a forum to facilitate people to think collectively and to
organize an intelligent neural network of colleagues.>>
Agree 100%.   Why is it not happening?   I venture to suggest that the real
radical thinkers of our profession are out doing other things, rather than
sitting on committees.  Let's face it, being active in the College involves
a lot of committee work.  
While the way to set up thinking networks which get things done is
certainly NOT by committee. 
 We all have our networks of mutual help;  with colleagues, specialists,
other professionals.   We built them up mostly by meeting face to face or
on the phone.
 But the person who works by committee does not understand that approach
and has all kinds of worries about it all going wrong because one person
might say something which had not previously been proposed, seconded and
voted in.
Utter bullshit! The world no longer works that way and it is high time we
all changed our ways.
So how do we organise neural networks?   Anyone using that word will know
that it refers to a branching interlinking net-like system of nodes or
thought centres or  brain cells with the likelihood that a signal (idea)
from one of those cells/nodes will in time diffuse to all the others,
picking up new bits on the way.   Totally different from the typical
computer, no matter how powerful and much more in tune with our own brains
and how we learn.     
Well the last thing we should do is set up a committee!!!   I propose in
fact that lists like this one are a primitive form  of neural network,
likewise the medical forum on compuserve----ideas or questions are posted, 
others join in and if it goes right the thread evolves and the end result
is a great advance on the start.  
The non-electronic equivalent is the (moderated) workshop----and we all
know how little of that method we have in GP education. 

<<only problem with the RCGP at present is that the membership is too
passive
(apart from bursts of hot air)>>>     I strongly disagree----and I have had
plenty of experience of passive GPs in other areas of activity apart from
the RCGP  and I agree that passivity is a big problem in GP----when you see
the awesome efforts even those very active in the RCGP have to make to get
a point made or a suggestion accepted then you realise that there is
something fundamentally wrong with the structure. Personally I think there
is a lot wrong with some of the senior college people too but I'm sure many
would disagree. 
<<There is no reason on earth why a
resurgance of scientific enthusiasm among "real gps" would not transform
the college back into a thriving hotbed of exciting development. For gods
sake! What is the alternative? >>
It is rather difficult to do scientific research in a work environment
where you trudge home every evening from the surgery, where you long for
Friday to get a break from the patients and where you see colleagues
cracking up under the strain. I did all the audit I could and took part in
one or two drug trials and would have done a lot more but work in a
deprived area just wears you out.  A chance at having a RCGP research
fellow for a few months would have been wonderful and a simple but very
effective example of how the RCGP could benefit frontline GPs, help produce
research and win great kudos for itself.  Personally, if I go back to
practice and do some research, I shall be more inclined to share it with
colleagues with my area. 
You ask what is the alternative. The alternative is for the college to do
what some of the most successful and imaginative big companies have been
doing for several years now----to shut down the central organisation and
machinery (except for library facilities which are not available elsewhere)
and get its active members out into the wilder parts of GP land.  Get them
out roving around and spreading the gospel; get them away from the nice
cosy academic circuit where everyone knows everyone else; get them out to
the deprived areas where GPs are scarce, to the rural wildernesses where
they face thirty years on a one in two.  Get them out to help, not to
lecture.
Can you imagine the effect if a fire-breathing but down to earth heavy duty
researcher like Tom O'Dowd came out frequently to meet GPs in my area? Went
to surgeries and talked research, got GPs curious, encouraged ideas, had
some pump-priming money,  ran a few meetings on basic research methods.
Do you see? It is not just the idea of research, not just the methods,  the
personal exemplar is vital and the personal passion and commitment is even
more important.   Pity there aren't more Tom O'Dowds around but we can
look, we can find fire-breathers and teach them about research, give them
some time in a nice dept of GP practice or a nice training/research
practice and then turn them loose.
Nothing will happen as long as old men walk around Princes Gate with fancy
robes on them; we don't need that stuff anymore.

Anyone else got ideas on this?
Declan

 


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