Now that the White Paper has formally identified patients as 'healthcare consumers', the new priority for GPs seems to be the marketing of their wares.
This is reinforced by the latest changes to the quality framework, which aim to reward practices not just for being accessible, but also for being perceived as such by their patients.
Many GPs might be feeling uneasy about pushing their practices forward into the limelight.
However, GP-friendly marketing packages, including branding, logos, mission statements and loyalty programmes are now being developed both within the profession and by outside consultancies. What is more, some GPs welcome them.
'We're not very good at trumpeting our achievements because it can feel too much like showing off,' says Derbyshire GP Dr David Holland, whose single-handed practice achieved maximum quality framework points in all clinical areas.
'It's something we have to get used to doing, though not least because patients want the information.'
Another enthusiast, Dr Elizabeth Barrett, is faced with the threat of a GP practice, backed by a multinational healthcare company, opening up close to her 10-doctor practice in Nottinghamshire.
She says that seeing services from the consumer's point of view is essential for the practice's well-being.
'Branding and promotion are becoming a necessity for GPs, because the competition will be promoting their services and probably spending a lot of money on it,' she says.
She adds that to survive, GPs will have to show why their practice is better than the one down the road.
For the past three years, both practices have helped to pioneer an online tool that allows primary care teams to market their achievements, individually and in comparison with other practices.
The tool also provides a mission statement, factual information about opening hours, services and staff, alongside patients' views and an assessment by a 'mystery shopper' - a market researcher who visits the practice anonymously.
Known as PRIDE (Public Release of Information: a Developmental Evaluation), the service was developed and piloted by Manchester University's Primary Care Research and Development Centre, based on findings from a series of focus groups on what the public want from general practice.
The result is a new website, www.yourgpguide.org.uk which opens to all GPs this month.
Putting your service's details on the site is free to the first 150 practices that apply. For others, the cost is £250.
'Even three years ago, it was obvious that general practice would follow the path of school league tables and hospital star ratings,' says research associate, Jenny Noble who worked on PRIDE.
'We wanted to find out how information about practices could best be presented, and discovered that people did want to be better informed about GP services.'
Patients want to be treated like customers 'even if that doesn't necessarily mean they want to behave like customers'.
Ms Noble has a local newspaper cutting headlined 'Just how healthy is your surgery?'
The article lists practices according to quality framework data and includes GPs from poorly performing practices who were door-stepped by a reporter.
'I show doctors this to demonstrate what happens if practices don't take control of quality framework and other clinical data,' says Ms Noble.
Essex GP Dr Rory McCrea and a partner took over two 'previously challenged' practices in Waltham Forest five years ago.
'We felt overwhelmingly that the patients needed to feel confident in their practice, to have the feeling that it was professionally run and willing to involve them,' he says.
Since then, time and money have been invested in developing a brand and, nowadays, Chilvers McCrea Healthcare, of which Dr McCrea is chairman, has NHS contracts to run more than 15 GP practices.
Whether you are thinking of following suit or are concerned with whether your own practice can face down rivals, the success of Dr McCrea's company is worth noting.
To help foster consumer involvement, Dr McCrea turned to consultancy Marketing in Practice.
Run by Sonia Job, who moved from marketing the pharmaceutical industry to marketing general practice when she realised how many GPs ran clinics that patients were unaware of, the consultancy charges negotiable fees.
'Marketing is seen as an expensive luxury,' she says. 'But devices such as logo design, branding signs and notice boards, websites and local PR, all add value and encourage patient loyalty,' she says.
Meanwhile, the PRIDE website has been endorsed by the RCGP whose chairman Dr Mayur Lakhani is a marketing enthusiast.
'People don't want their GPs in league tables,' he says. 'Nor do they want a free market model where unprofitable practices have to close down.'
He stresses that patients want to feel that their doctor is listening and that they also want as much information as possible about what their surgery offers and how it is performing.
- Contacts: PRIDE project, (0161) 275 0612; Marketing in Practice, (0118) 903 4040
CASE STUDY - OPEN ALL HOURS IN ESSEX?
Essex GP Dr Diana Lowry is outraged that her three-doctor practice might soon be expected to provide a 'dial-a-pizza service' to their 6,000 patients, opening weekends and evenings as well as the two surgeries every weekday.
She has asked Marketing in Practice (see main text) to help her remind the local population of the accessibility, the continuity of care, and traditional values of the high-street practice.
'It goes against the grain to consider anything approaching advertising. But if a multinational company was to put a GP in the local Tesco next week who offers quick-fix, walk-in appointments, then local people, especially commuters, might be tempted,' she says.
As the smaller of two surgeries in Epping, until now the practice has never worried about competition. The practice has always nurtured a traditional identity, with pictures of former partners on the corridor walls and receptionists in smart uniforms. Now, with help from the consultancy, it is investing in a two-way dialogue with patients, starting with a regular, professional-looking newsletter and a revamp of its image.
'Our patient survey shows that people are happy with our service. Now we need to make sure they realise it too,' she says.