The problem with writing any column like this is the inevitable gap between my writing it and you reading it. As I write, it is bitterly cold outside. As you read, the sun may be shining and you may be revelling in the most beautiful of crisp winter days. But my guess is that you will be shivering too. It looks like it's going to be a long and very cold winter. Indeed, whatever your views about the cause, there seems little doubt that the changes to our climate seem likely to become more and more dramatic as every year goes by. We are having hotter summers and colder winters. The impact on our lives as GPs may be very considerable, particularly when it comes to home visits, and even more so for those of us who live in the country - though having seen the devastating effect that an inch of snow can have on central London, rurality may not be the sole marker of transportation chaos...