Celebrating his centenary year, this is the closing part of an address given to members of the BMA in Wales by Dr. Lloyd-Jones in 1973. It appears in Healing and Medicine, published by Kingsway.
I put in a plea for a new order, for a new conception of general practitioners, and in addition, general consultants as well. As a young man I worked for some six years with Lord Horder. He was not a specialist in any one department. He was a general consultant, and that was, I think, the genius, the great value of the man.
A watchdog and a guide
So then, what is the general practitioner or the general consultant to do? I would say that his main function is to keep an eye on the experts. Have you heard Marshall McLuhan's definition of a specialist? He says that a specialist is one who never makes a small mistake while moving towards the grand fallacy. He never makes small mistakes. But what about the grand fallacy! So that is the first business of the general practitioner - to keep his eye on the expert. He does not finish with the patient when he sends him to the expert. Follow him on, keep an eye on him, help the patient decide. It is a terrible thing for a poor patient to have to decide whether or not to have an operation advised by the special. The general practitioner is to be there by his side, and to help him. And he is to keep an eye on the treatment of the whole man, when the specialist tends to look at only part of the man. What are the guiding principles?
A man of humility
The first great need is humility. The greatest danger of all as a result of this phenomenal advance in medicine is for medical men to claim too much, to speak beyond their knowledge, to speak beyond their right to speak. I notice increasingly the humility of the great Nobel Prize-winners. What do we really know about the brain? We talk about manipulating it, changing it, affecting it. What do we really know about the mind? What do we really know about either of these? And the answer is - very little. And yet people play with these new drugs with impunity, not realising they are going well beyond the knowledge which they possess.
A man of humanity
Remember the great Hippocratic principle: do no harm. But I want to go beyond that and to put it in a positive form. Do unto others what you would have others do unto you. It is a very good test. If you are confronted by the question of one of these clinical experiments, look at it in that way. Would you like to have this catheter pushed down your veins and into your heart? Would you like it to be done to you? Above all, be concerned for people as people. Be concerned for the whole man. Never was there a greater need for character in medical men - understanding, sympathy and patience. Yes, and self-sacrifice.
The doctor of the future
I would like to see a new order of general practitioners coming into being; men who are prepared to be counsellors, in a general sense. They can send off their patients to the specialists and experts as the need arises, but they will still maintain their hold of them. The patient can go back to them because they are always in charge.
Surely this ought to appeal to many young men and women today. The doctor in the community - I believe he is, in many ways, going to be the guardian of personal liberty. He alone can do it, I think, because everyone will turn to him because of his expertise. I think personal liberty may well be in the hands of general practitioners of this type in the years that lie ahead, and it would be a wonderful thing if a body, an order of men and women emerged holding this high exalted view of the general practitioner in society and in the community, serving the public.
Such are my ruminations about medicine in modern society. Some of you, no doubt, have been amused at the obvious conflict that has been going on between the lecturer and the preacher, while others have diagnosed an obvious case of schizophrenia! Well, whatever your diagnosis, all I say is that as one who has a profound respect for this great profession, I hope I have been able to convey to you this one idea, that there is still a paramount need of those ideals and motives and thoughts, which moved and impelled a man called Rahere to found St. Bartholemew's Hospital in 1123.
Rahere was the Canon of St. Paul's Cathedral who in 1123 AD founded St. Bartholemew's (where Dr. Lloyd-Jones trained) on its present site. Although there has been much change in the practice and organisation of medicine since 1973, the need for humility and humanity in the practice of medicine remains and still speaks to us today.
