“You’re an expert in me”: the role of the generalist doctor in the management of patients with multimorbidity

It is not often that a single patient successfully symbolizes almost every important trend in modern medicine, but one particular man achieved this in a solitary consultation. He was a patient in my general practice. He was 77 years old ? exemplifying the ageing population, and had only lived in my area for 3 or 4 years ? exemplifying an increasingly mobile population. I knew him well and saw him often ? combining an aspiration for continuity, and increasing consultation rates in primary care. He had prostate cancer, but he also had hypertension, diabetes, coronary artery disease, macular degeneration, hyperlipidaemia, an arthritic right hip, and, hardly surprisingly, depression. This was multimorbidity par excellence. Journal of Comorbidity 2015;5(1):132?134