The report thus has turned into an academic autobiography, starting with a description of the life events and influences which shaped Howie's subsequent choice of professional priorities.
His first theme is about structure. In this he writes about the negotiations he led over the ten years to win a share of SIFT/ACT (the English and Scottish subsidies to hospitals to support teaching) for general practice.
The second theme about the process of care traces the story of his team's research into the determinants and delivery of quality care at general practice consultations, concluding with the view that longer consultations and better continuity improve patient outcomes - and may be more likely to be delivered by doctors working in smaller rather than larger practices.
The report is above all an attempt to show the importance of the interplay between beliefs and visions on the one hand and data and theory on the other. Will this message be as true in the future as it has been in the past?
Howie D (1999) Patient-centredness and the politics of change: A day in the life of academic general practice. Nuffield Trust.