Beyond single and dual diagnosis in general practice: Editorial's  multiple authorship poses difficulties

doi:10.1136/bmj.326.7399.1145

BMJ 2003;326:1145 (24 May), doi:10.1136/bmj.326.7399.1145

Letter

Beyond single and dual diagnosis in general practice

Editorial's multiple authorship poses difficulties

The first 150 words of the full text of this article appear below.

EDITOR—In their editorial Wright et al refocus attention on the inextricable links between poverty and poor health.¹They introduce a new term to describe these health problems,"multiple morbidities."

This is a biomedical construction if ever I heard one, a publichealth obfuscation. I do not disagree, but the editorial'smultiple authorship fails to drive home the key points in afragmented article. The irony (and I am sure it is not loston the authors) is that multiple authorship has inadvertently subverted the clarity of the work.

The issue is not that primary care lacks specialist credentialsor that secondary care has become too specialised but thatcommunication across the interfaces continues to be absurdlyprimitive. Part of this is a reflection of inadequate staffing,poor management, and an antediluvian records system; some isa question of attitude, especially among inexperienced, simplyignorant, or poorly led secondary . . . [Full text of this article]

James N Hardy, general practitioner principal

Bethnal Green Health Centre, London E2 6LL james.hardy@gp-F84083.nhs.uk

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