Clin Med
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We all know people with tone deafness: these are the people who get thrown out of the choir at school. Although tone deafness is recognised as an output disorder, recent studies have characterised it as one of music perception in the absence of deafness or any associated cognitive disorder. The disorder can therefore be characterised as a form of auditory agnosia. ⋯ Studies of multiply affected families are underway to see if the disruption of this network can be caused by single genes. This disorder therefore offers the opportunity to study how a complex phenotype can be characterised as a cortical perceptual disorder potentially explained by a single gene or molecule. Although tone deafness is not pernicious, the underlying abnormality may prove to be a disorder of cortical connectivity that provides a model for disorders that are more so, such as schizophrenia.
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The key to any successful healthcare system is the recognition of the inseparable partnerships between the individual patient and their doctor. Diseases can be studied in populations but in contrast, patients are individuals and must be respected as such. There are several reasons why this partnership has been eroded as the NHS evolved over the last 60 years. ⋯ There is an urgent need for government, management, the medical regulators, the profession and patients to work together, mutually respecting and trusting each others' complementary skills, responsibilities and needs. Consultation with any of these groups alone has not and will not resolve the problem. The colleges working with patients now have a leading opportunity to ensure that whatever changes are introduced into the NHS, this crucial partnership is recognised as the enduring linchpin in quality medical care of patients.