In this issue of the Journal, Dr Y T Wun¹ writes on the confusing aspects of the terminology and the definition of the discipline that we practise. We know too well that this is not a recent event.²

According to Dr Wun, there is still a lot of confusion in both name and content about our discipline even among our colleagues. If it is really so, it deserves our utmost attention to resolve this unsatisfactory situation without delay. Our College was known as the Hong Kong College of General Practitioners for many years but it was changed to Hong Kong College of Family Physicians in 1997. Why did we do it?

Dr Stephen Foo, the President then, explained in detail the rationale for the change in August 1997.³ He wrote, "The new terms give us a new start, a new image, a new chance to show that we are equal in standing academically and professionally to any other specialist colleague, provided new entrants into our discipline are rigorously trained and experienced". His emphasis on training was most evident.

Five years later, with nearly 300 trainees, family medicine has quickly become the single largest vocational training programme for young doctors in Hong Kong. This was probably unconceivable even to Dr Foo when he wrote his editorial in this Journal five years ago when the trainee number was only a fraction of what it is. This latest thrust of the development of the discipline in Hong Kong is in line with the world trend that the aim of the undergraduate course is to produce undifferentiated graduates who are equipped to undertake postgraduate vocational training which includes general practice/family medicine.⁴ The discipline of general practice/family medicine is therefore a unique discipline. It has a body of knowledge and skills that can only be acquired after a period of vocational training. Our forefathers in Hong Kong, like other general practitioners in other parts of the world, learned the discipline by blundering through their own experiences. The time has however changed. It is unlikely that the rising expectations of today's patients would allow this to happen. As a matter of fact, such untrained medical personnel may have difficulty to compete in the highly competitive medical market which expects a high level of professional competence.

As our discipline is now undoubtedly a distinct and unique one, why do we still have difficulty with the terminology ourselves? The term "general practice" has been used in some Western countries e.g. Britain and Australia for many years and it is well accepted. Their general public would have little difficulty with it. I think the Chinese terms general practice (全科) / general practitioner (全科醫生) are providing us with more difficulties. These terms are confusing² and they were probably never fully adopted nor understood by the general public in Hong Kong. I am not certain if many of our colleagues are actually using these Chinese terms. On the other hand, was Dr Foo's rationale fully accepted by most members of the discipline?

The strength of the discipline lies within its members. If there are indeed very divided views on the use of the term that signifies the profession that we practice among ourselves, something ought to be done.

As a major health reform is impending in Hong Kong and the importance of primary care is increasingly being recognised, there should be no further delay in sorting out these confusing situations. As I said earlier, a sharp and clear image of our discipline would help bring about a paradigm shift of the health care system of Hong Kong.⁵ We need a united front.