For better or worse, healthcare has become a commodity. In London where I work, there has been a huge shift of mostly younger patients registering with the kind of services which seem to offer instant gratification. These patients are moving in droves away from the stable "register with a general practice surgery near to where you live" to the online and telephone services they can access on their phones. These are "consumers" who don’t want face-to-face or continuity of care. They just want to get sorted as quickly as possible and wherever they happen to be. They won’t wait 3–4 weeks for a routine appointment. Whether we like it or not, these services are meeting a demand that has taken most of us by surprise.

There …