They will acquire new skills as well as excel in their traditional work. They will share their evolution with others who may also change and take up new positions on the clinical landscape. Territorial dinosaurs will continue to roam the planes. Ever more exposed, ever more out of touch and destructive. As the armoury against them becomes more potent they will either be picked off one at a time or trundle off noisily over the horizon in search of new homes leaving a trail of destruction in their wake.
Clinical governance is neither a panacea nor an optional extra.
It is a requirement. Its effect may be to act as a catalyst in the development of primary care or the means of its dismantling. It will lead to improvement or engender an industry in ever more devious ways of beating the system. We will either spend our resources working for and with our patients or waste energy trying to preserve the status quo. There are many ills in medicine that will not simply respond to reorganisation or dialogue.