Corridors and towers.

Editorial Corridors and Towers When C P Snow wrote "The Corridors of Power" he sought to demonstrate the inner workings of the political process in Whitehall. Now that we are coming towards the end of the useful life of the building known as the "RVH corridor" it is time to consider some of the inner workings of our own profession. Wards 1-20 in the Royal Victoria Hospital represent only a small part of that institution and there are other corridors connecting different parts of the building which we would do well to try and forget. But the main corridor achieved a special significance for students, doctors, nurses and, in earlier days when it represented the state of the art, for our patients. Now we have the BCH Tower which might be considered as a series of superimposed islands with little communication between them, except for the occasional meeting in the constrained environment of a lift shaft. But there is no doubt that our patients appreciate the facilities of toilets and showers and bathrooms and privacy when they are ill. Those who are planning new buildings must always remember that medicine in the future will be different from the present. The old poor,law terminology of inpatient and outpatient is becoming irrelevant as people move rapidly from one phase to the other. The concept of consultations or even of operations will become blurred. Specialists will become increasingly specialised leaving an important space for the generalist, whether he or she be called physician or practitioner. The architect must remember that although day patients have no visitors they do each have a car and a driver and they will need just as much toilet and washing space. The concept of disease orientated medicine will demand a more integrated care for the patient in outpatient, daypatient and inpatient facilities by the same professional staff. This disease orientated concept requires a structure which has existed in some buildings but not in others where inpatient and outpatient facilities have been totally separate. Buildings to some extent set the pattern of practice and they offer an opportunity for flexibility in the future. In this issue, Professor Reilly in his presidential address confronts the interface between general practice and hospital-pFactice. A quick glance at the Osler or hospital paradigm, and the Reilly or general practice viewpoint, would suggest that they differ only in the addition of a fourth angle …