Theoretical analysis has suggested that so-called threats to professional autonomy in the United States might also be manifesting themselves in the United Kingdom through the introduction of market principles and the new "managerialism" into the National Health Service by the government and through the emergence of complementary medicine and the role of the "articulate" consumer. The authors explore these issues by focusing on how a sample of the "rank and file" of general practitioners perceive these potential challenges from "above and below." The evidence suggests that the social, economic, and clinical freedoms of general practitioners remain intact although these external influences appear to have changed the style of clinical practice, which is a source of concern and dissatisfaction to some general practitioners.