Ham: There seems to be an astonishing range of expectation from this group as to what a general practitioner (GP) will do for his or her patients, ranging from screening only through to being the primary manager. I feel that we are expecting a fairly high level of sophistication from the GPs within an average British, Canadian, or American family practice. I think we need to be aware that, for some time, the core recommendation in the USA has been to assess the patient using the Mini-Mental State Examination (MMSE) or the Clock Test and perhaps two or three other quantitative assessments. Noncognitive features, such as behavior, are harder to quantify and the individual who assesses them must be the patient's primary manager. It will increasingly happen in the USA that as care becomes more managed, a greater emphasis will be put upon primary care.