The choice of using a case study as a research technique may be controversial in terms of the hierarchy of evidence. It is not clear to what extent a single case can provide more general information, however according to Stake  each case is both individual and general, since we can usually find both specific and typical elements. The principal epistemological value of a case study is well expressed by the Latin maxim ‘non multa sed multum’ (not many but much).
Qualitative case studies are uncommon in medical research. However, novel research issues necessitate a flexible approach to the selection of methods and techniques. A common rationale for the performance of a case study is that an in-depth analysis of a single case will contribute to the understanding of a wider issue. Therefore, the choice of case research makes an essential contribution to increasing our understanding . In the present study, assessment of an individual case provided a more comprehensive picture of older patients’ perceptions of the role of the family doctor in health promotion. The language used by our patient to describe his expectations provides specific information concerning the impact of health promotion interventions on older patients. By getting to know not only a patient’s opinions, but also his feelings, experiences, behaviors and expectations, we gain both understanding and practical benefits. Firstly, it shows the need for an individual approach to patients and identifying their expectations of care. Secondly, it provides practical information on how to deal with this during the visit. Lastly it emphasizes the need for a flexible mindset; health promotion is relevant even at 80 years old!
Member checking was used to substantiate the quality of the data analysis: our patient confirmed the accuracy of the interpretation of his opinions and expectations. This did not negate the principle that the positions and roles of the respondent and the researcher are inherently different .
The present study provides new insights by assessing the issue of health promotion from the perspective of a patient. Our patient felt that the family doctor has a role in the maintenance of the physical and mental skills of older patients and in encouraging them to form social bonds within their communities. He expressed the opinion that the family doctor should be an educator concerning the issues of smoking, alcohol use, physical activity, nutrition, medication and coping with stress. He also referred to the role of the family doctor regarding the issue of personal hygiene, which is rarely discussed in the literature. Our patient himself touched upon key health promotion issues described in a variety of studies [1–3, 8]. This case study highlights the importance of a flexible approach to consulting; our patient himself articulates his expectation of health promotion at age 80.
Health promotion is a very broad term and takes into account a wide range of factors that encompass the health of an individual. This paper concerns only individual lifestyle factors and the health services of a family doctor. Our patient perceived the doctor as a ‘key person’ in health promotion. His expectations are consistent with evidence-based guidelines on health promotion for older people. An important recommendation is to ‘enable older people to improve their independence and autonomy through increasing practical know-how’ .
Our patient in the present study was relatively well from the perspective of his physical and mental condition and he had stable family, social and financial circumstances. He took personal responsibility for his health, was conscious of negative health behaviors and was willing to cooperate with his family doctor.