From a The BMJ online editorial:
The proportion of patients who have two or more medical conditions simultaneously is, however, rising steadily. This is currently termed multimorbidity, although patient groups prefer the more intuitive “multiple health conditions.” In high income countries, multimorbidity is mainly driven by age, and the proportion of the population living with two or more diseases is steadily increasing because of demographic change. This trend will continue.
Cluster medicine
The cluster around diabetes is a good example, with the common serious disease affecting the heart, nervous system, skin, peripheral vasculature, and eyes. Diabetologists already provide care for the cluster of multiorgan diseases around diabetes, and some specialties, such as geriatrics or general practice, have multimorbidity at their heart. For most, however, training and service organisation are not optimised to face a multimorbidity dominated future.
The shift includes moving from thinking about multimorbidity as a random assortment of individual conditions to recognising it as a series of largely predictable clusters of disease in the same person. Some of these clusters will occur by chance alone because individuals are affected by a variety of commonly occurring diseases. Many, however, will be non-random because of common genetic, behavioural, or environmental pathways to disease. Identifying these clusters is a priority and will help us to be more systematic in our approach to multimorbidity.
Among older adults age 50–80, 43% had ever reviewed doctor ratings; 14% had reviewed ratings more than once in the past year, 19% had done so once in the past year, and 10% had reviewed ratings more than one year ago.
Ratings and reviews for nearly everything can be found online these days, including doctors. How are older adults using these ratings in their decisions about choosing doctors? In May 2019, the University of Michigan National Poll on Healthy Aging asked a
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