The management of painful, upper-limb disorders by 34 general practitioners (GPs) was examined 3 months before and 3 months after personal instruction of GPs by a consultant rheumatologist. Tuition was conducted either in GP surgeries or a hospital out-patient department. Following instruction there were significant increases in the application of appropriate treatments (p<0.0005) and of local corticosteroid injections by GPs (p<0.005), fewer requests for investigations and less-frequent hospital referrals for consultant rheumatology opinions. Hospital out-patient instruction was associated with a significant reduction of patients' time off work (p<0.005) and, in general, differences of management appeared to be more pronounced amongst those GPs instructed in the hospital than in GP surgeries. The study showed that personal instruction of GPs by a consultant rheumatologist may result in modifications of practice, at least in the short term. The evidence indicates that such alterations of GP management may significantly reduce patient morbidity.