It was in 1967 that the first patient went from Tunbridge Wells to the Brompton Hospital for pacemaker implantation. The recipient was a typically robust female octogenarian and while the eminent cardiologist was engaged in his task, she tapped him on the shoulder. “Young man” she said, “how many of these operations have you done?” He replied, somewhat modestly, “About 300,” expecting her to compliment him on his expertise. Instead, she said “Well, if you've done that many you should know to keep your patient's feet warm. Cover them up!” This anecdote aptly illustrates the contention implied in my title that a new and somewhat disruptive dimension in the form of technology has entered the field of medicine, a view which has attracted considerable support from various quarters (14; 16).