Ongoing scientific and technical progress in medicine concentrates on diagnoses and diseases instead of eliciting the ill-health perceived by the patient leading to “too much medicine” particularly in old and very old patients. There is clearly a need of prioritizing medical intervention. The criteria for differing between useful and less necessary medicine could be the effect size of individual measures on the preservation and recovery of functionality. In order to do so, functionality must be made describable. One useful tool is the International Classification of Functioning, Disability and Health (ICF). Current ICF contains a high number of codes and is therefore hardly used by doctors to describe their patients’ health status. ICF in its actual state is clearly too complex to be implemented in general practice routine.
There is an urgent need for so called ICF core sets. These core sets are lists of selected ICF categories relevant for describing the functional health of relevant patient clusters. By using eligible core sets the impact of medical measures and treatments on geriatric patients could be investigated. Our thesis is that focusing on functional health with geriatric patients would lead to the reduction of overtreatment and overdiagnosis. Within the next three years we will develop a primary care core set.