The Dutch Journal of Medicine celebrates 150 years of continuous publication and looks forward to the next 50 years, notwithstanding the hazards offorecasting. In the coming years, the practice of medicine will see more teamwork and more specialisation, but the core process will remain personal counselling by a physician who manages to address somatic and psychological factors. Medical research will continue to include patients as well as molecules, but clinical trials will be threatened by overregulation through bureaucracy and legalism. Despite easy access to search facilities in the digital era, the future of general medical journals in local languages seems assured, because physicians need to keep abreast of developments in other specialties; the only uncertainty is whether these journals will continue to be read on paper.