Despite remarkable international differences, most European health care systems rely on a primary care, a secondary care and more specialized or tertiary institutions, which often focus mainly on one organ or system. Nonetheless, the continuous increase of chronic comorbidities that is secondary to ageing of the general population, imposes a global treatment approach, which goes far beyond the highly specialized management of a single acute, or acutely decompensated, index condition. In this evolving epidemiologic scenario, a general Internist working in academic, highly specialized settings, may valuably contribute to improve the effectiveness and cost-effectiveness of a focused, single specialty approach [1].