Managers attempt to hijack community medicine.

In a recent leading article on Griffiths in action the British Medical J7ournal suggested that the tabloid headline might have been "Administrators hijack NHS."' Hence the title for this article, which captures the essence of my experience of a course held at the King's Fund College. This was the introductory week of a two year training programme for registrars in community medicine; most of the week was devoted to management. Many of us are well aware of the unresolved debate about whether community physicians are applied epidemiologists, practitioners of public health and preventive medicine, or health service managers. So I found the emphasis of the course somewhat surprising. It was as if the debate had been resolved in favour of the managers. Indeed, there is a faction in community medicine that argues that community physicians should become managers if only to rectify the