With the increased application of recent technologies such as the Internet, CRM and advanced software capabilities, it has been suggested that the time has come for a debate on a new paradigm for knowledge management. As a contribution to this debate, this paper will examine a case study of an outpatients clinic in an Australian public hospital with the objective of gaining a better understanding of the issues related to knowledge transaction in communities of practice. A tentative knowledge dynamics model is proposed to stimulate discussion and future research