Year Three - Realistic Medicine

Question 1

What are the risks of over investigating and over treating?

Answer 1

Hidden harm

Providing care that is of lesser value

Question 2

How should waste in healthcare be assessed?

Answer 2

In interventions that do not add value for patients rather than physical objects (i.e needles, surgical equipment etc), that are thrown away

Question 3

How must we eradicate “doctor knows best” culture?

Answer 3

By ensuring patients are comfortable in sharing their experience with doctor so they can begin to share the power and responsibility of decision making

Question 4

What is the aim of realistic medicine?

Answer 4

To

• build a personalised approach to care
• begin the process of shared decision making
• reduce unnecessary variation in practice and outcome
• reduce harm and waste
• manage risk better
• become improvers and innovators (Wtf??)

Question 5

How can we build a more personalised approach to care?

Answer 5

o Use tool to estimate individual’s risk of event occurring eg assign-score or Qrisk2
o Inform patient of relevant data
o What stage of the cycle of change are they at

Question 6

What are the consequences of overdiagnosis?

Answer 6

o Overdiagnosis  cascade of medical, social, economic consequences follows- some of which are permanent. The medical label and the ensuing treatment take an emotional and financial toll on the person, while costing the health system

Question 7

How can we make improvements and become innovators?

Answer 7

o Emphasis on using data to support discussions and learning in clinical teams is already an established approach within general medical practice

o AUDITS : inform + design ways that routine data can be used to design routine quality + monitoring and improvement systems across the country

Question 8

What 5 questions should patients ask their doctors?

Answer 8

• Is this test/ treatment/ procedure really needed?
• What are the potential benefits and risks?
• What are the possible side effects?
• Are there simpler, safer, alternative treatment options?
• What would happen if I did nothing?

Question 9

How many people are comfortable asking their doctor about treatment and care options?

Answer 9

92%

Question 10

How many people actually speak to their doctor about their treatment and care options?

Answer 10

67%