The early years of the NHS have been characterised as ‘provider capture’ by opponents, with services organised around professional interests rather than patients. This analysis, whilst flawed, has influenced subsequent attempts by politicians to manage medicine. Such an analysis when applied locally illuminates the diffuse and ethereal influence wielded by doctors in the realisation of services. Drawing on archival and published sources relating to the Lancaster Medical Book Club, this paper contextualises how competing professional, educational and social purposes of medical association influenced local leadership in the early years of the NHS from the 1940s to the 1960s.