There seems to be a continuing series of negative news in the community this year. All we seem to hear about are pay freezes, unemployment, falling interest rates and property prices. It is understandable that all this makes people increasingly gloomy. What is fascinating, though, is that everyone seems to be saying the same sort of thing. There are of course answers and solutions, some of which will take courage to implement. Perhaps we really need to start on the road to restructuring. It might not all be pleasurable, and it will need the goodwill and cooperation of the whole community to succeed. If tackled with enthusiasm, we will get the job done once again.

What about problems in the medical arena? Amongst our profession, likewise we hear about unfavourable contract terms and cutting of benefits in the public sector, lack of posts for new graduates and threats from insurance companies and HMOs to cut our professional fees in the private sector. Solo practitioners experience the loss of patients to Managed Care groups. The world is a resilient place and we should follow the determination of "New York City" to return to business as usual after the 911 incident despite the negativism that is so abundant. It is time for all of us in Hong Kong to deliver our formerly famous "one step ahead" maxim to ensure that our profession has a future. For family physicians, this means continued self-improvement and development. It means the need to continue to modify patient culture and behaviour and to change patient's value and expectations. It also means the need to provide innovative services focused on prevention, health screening, life style modification and patient education. Only then, will we be rewarded for our efforts and be entitled to receive the remuneration we deserve. Our College will continue to organise activities to assist our members in their continuous professional development. I report with enthusiasm that after ten years of planning, we have finally launched an ultrasound course for general practitioners this year. Continuous Medical Education (CME) suddenly became the talk of the town this year. Whereas our College is now moving on to advocating Continuous Professional Development (CPD) for our fellows, there seems to be a struggle for the power to organise and accredit CME for doctors not registered as specialists. Many of our members were disappointed and angry that our College had not been invited by the Medical Council to administer, provide and accredit CME for theses doctors. The matter has now been resolved. The Hong Kong Academy of Medicine acknowledges and recognises the experience and success of our College in organising CME activities and has resolved to delegate the duty to our College.

The holistic care offered by Family Physicians will continue to be in demand and the public appreciates the comprehensive, continuous care offered by family practitioners. More and more individuals understand the concept of Family Medicine and earnestly look for Family Doctors to take care of themselves and their family. So hold your head high.

Enthusiasm is contagious, start an epidemic - Don Ward.

At the end of a most extraordinary year that will be indelibly imprinted in our memories, best wishes for a more successful New Year.