From wholes to fragments to wholes—what gets lost in translation?
ForfatterKirkengen, Anna Luise
The highly demanding and, in a certain sense, unique, working conditions of general practitioners (GPs) are characterized by two phenomena: First, they involve an increasing familiarity with individual patients over time, which promotes a deepening of insight. Second, they enable the GP to encounter all kinds of health problems, which in turn facilitates pattern recognition, at both individual and group levels, particularly the kind of patterns currently termed “multimorbidity.” Whereas the term “comorbidity” is used to denote states of bad health in which 1 disease is considered to predate and evoke other ailments or diseases, the term multimorbidity is applied when finding several presumably separate diseases in a person who suffers from them either sequentially or simultaneously. Encounters with patients whose suffering fits the biomedical concept and terminology of multimorbidity are among the most common which GPs face, presenting them with some of their most demanding tasks. The term multimorbidity needs to be examined, however. As it alludes to a multiplicity of diseases, it rests on an assumption of separateness of states of bad health that might not be well founded. An adequate determination of what to deem a “separate” state of bad health would require that the biomedical concept of causation be scrutinized.
This is the pre-peer reviewed version of the following article: Kirkengen, A.L. (2018). From wholes to fragments to wholes-what gets lost in translation? Journal of Evaluation In Clinical Practice, 24(5), 1145-1149, which has been published in final form at https://doi.org/10.1111/jep.12957. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Use of Self-Archived Versions.