Kevin is a 65-year old GP who has worked for many years in an urban group practice with a group of GPs. He has a loyal following and is still working full-time. Lately he has been criticized by some of the younger members of the practice for not following the latest guidelines and there have been suggestions that he should cut down his hours and start to plan his retirement.  Kevin has never been to a GP and manages his own Type 2 diabetes and hypertension. His partners have suggested that he contact the Doctors Health Service.

Kevin is very concerned that his practice partners will report him to the Medical Board, though he thinks their complaints are trivial. The Doctors Health Service recommends that he make a long appointment to see a GP that they know will spend more time with him. The GP performs a full history, including family history and past history; performs preventive health checks as recommended in the RACGP Red book including screening blood tests, faecal occult blood, and diabetes and cardiovascular investigations. Kevin does not seem to have any cognitive impairment at the initial consultation but the GP refers him to a neuropsychologist for clarification due to the practice concerns. No further abnormalities are found on any of the investigations and his diabetes and hypertension are under good control. Kevin decides that he will decrease his hours anyway so that he can play more golf and see his grandchildren more often. He and his wife plan a cruise, their first holiday in 20 years that isn’t associated with a medical conference.