Komesaroff has performed a service in highlighting the impact of broader cultural and social trends on the professional organisations and, in particular, highlighting the perceived chasm between the Royal Australasian College of Physicians' (RACP) role as a supportive community of practice and as a mediator of community expectations and regulations.1 The diagnosis that these roles are seen to conflict and this creates tension may well be correct. The suggested prescription of a rigorous separation of these powers does not resolve this issue.