Tutorial 4 - realistic medicine

Question 1

Chief medical office

Answer 1

2015 - annual report

Question 2

Realistic medicine (2015) key points

Answer 2

build a personalised approach to care
change our style to shared decision making
reduce unnecessary variation in practice and outcomes
reduce harm and waste
manage risk better
become improvers and innovators

Question 3

Personalised care info

Answer 3

the use of data 
illustrate risk eg assign tool 
actual and relative risk reduction 
cycle of change 
need treatment?

Question 4

Guidelines - single disease

Answer 4

helpful starting point

many patients are multimorbid

Question 5

Overdiagnosis

Answer 5

prostate and thyroid cancers
asthma
CKD
ADHD

Question 6

Importance of overdiagnosis

Answer 6

medical, social and economic consequences

Question 7

Scottish intensive care society audit group

Answer 7

inform and design ways that routine data to design routine quality monitoring and improvement systems

Question 8

choose wisely UK 5 questions

Answer 8

is this test/treatment/procedure really needed?
potential benefits/risk
possible side effects
simpler/safer alternatives
what if I do nothing?

Question 9

Citizens panel report 2017 - good doctor

Answer 9

knowledge, good listener and friendly
feel listened to, clear communication and resolution
make decisions together