The 2022 GP: our profession, our patients, our future.

For the last decade or two general practice, indeed medicine in general, has been manufacturing ‘tools’ as if a 21st century industrial revolution was under way. Am I alone in my distaste and negative reactions, feeling that in most cases the word ‘tool’ is now used in a most ignorant and inappropriate way? Most patients know exactly what tools are, and use them to good effect in the real world. (I once used a tendon hammer, before I retired: a valued tool). Surely there are many more infinitely preferable words in the English language from which to choose, if concepts such as a scheme, plan, protocol, syllabus, or resource is really what is meant, for something intangible but intended to be teachable (if not necessarily memorable). While ruminating on why these etymological reflections have kept bothering me continually over the years, and as several dictionaries seemed to support me, I turned to the December BJGP to see if it was as ubiquitous as I thought. On the contents page, I read the very first entry: ‘page 621: European Antibiotic Awareness Day 2012: TARGET antibiotics through guidance, education, and ... TOOLS’ (my capitals).1 The last word triggered something in me — this local etymological mishap had now achieved a European, if not global, dimension. I even read the article, and found this four-lettered t-word not only appeared at the end of Table 1 (‘tools to use with patients’), but it had even secreted itself in the acronym ‘TARGET’ as well as in ‘toolkit’ (fortunately the acronym was suitably and considerately elaborated for those who can’t keep up with them). I looked back at the contents pages: ‘page 661: Writing therapy: a new tool for general practice?’2 This saw me reaching instinctively for my pen, to share these thoughts with the Editor. (Very therapeutic!). At this point I read on in the Journal, and was fascinated to find Neville Goodman’s ‘Familiarity breeds: clichés in article titles’; and barely surprised to find the errant word quoted in his last sentence.3 This monosyllabic t-word, although just a word, not a phrase, surely also has all the characteristics of a cliché, by his definition. It not only appears in article titles, but in the very fabric of our current medical literature, and it is time we called a tool a spade, or at least classed it with coalfaces as reprehensible management-speak.