Realistic Medicine Flashcards
What is realistic medicine [6]
Personal approach to care Shared decision making Reduce unnecessary variation, stick to guidelines Reduce harm and waste Manage risk better Become improvisers and innovators
What should a patient ask their doctor [5]
Is this test, Rx or procedure needed? What are potential benefits and risks? What are the SE of Rx? Is there a simpler, safer alternative? What would happen if I did nothing?
What reasoning do doctors use in patient management [4]
Hypothetico-deductive
Establish working diagnosis
Exclude rare non life threatening
Actively exclude life threatening with investigation
How do you improve clinical work [3]
Quality monitoring
Significant event analysis
Reflection
What is Wilson’s Criteria for screening [10]
Is illness a public health problem
Is natural Hx of illness understood
Will screening test detect pre-clinical stage
Is it sensitive ie - low false -ve and is it specific ie - low false +Ve
Is there a test available
Is the test and treatment safe and acceptable for patients and profession
Is the cost reasonable, is there an overall cost-benefit analysis to make treatment worthwhile
Is treatment effective
Is there facilities for Dx and Rx
Is prognosis better if Rx started early
