GOOD to hear from the first woman president of the Royal College of Physicians and Surgeons of Glasgow, Prof Jackie Taylor ("Our doctors and nurses need better support", Agenda, The Herald, December 11) that her priorities are workforce, their health and welfare and inclusivity. She also plans “to bring the interests of doctors in training to the centre of college activities”. Of course, in the college, she will spend most energy on those who intend a specialist career.

As a consultant geriatrician, along with GPs, she is one of the few remaining specialist generalists. It could be said that most of her younger colleagues prefer to be expert in narrower and yet narrower clinical fields – less to keep up with and focused options for research topics. She knows that while younger patients may have one disease, the majority of those seen in clinics and as in-patients are older with two or more acute or chronic conditions.

GPs have the task with their patients and carers of managing the uncertainty of new symptoms and explaining risk. When symptoms and ill health defy a diagnosis in primary care, it can be difficult to know to which speciality to refer. Good generalists available to refer to were invaluable and they often could factor in psychological and behavioural aspects, saving over-investigation. Perhaps colleges are encouraging physicians towards acute general medicine and to keep up their generalist skills alongside their specialism. Patients will benefit from that whether being assessed with acute illness on the day or when they need specialist opinion or investigation.

Dr Philip Gaskell,

Woodlands Lodge, Drymen.