Vision for realistic medicine by 2025

ALL healthcare professionals in Scotland will be practising “realistic medicine” by 2025 in a bid to increase patient involvement and reduce overtreatment.

That is the vision of Scotland’s chief medical officer Dr Catherine Calderwood in her latest annual report, Realising Realistic Medicine. It builds on the proposals and questions set out in her first report, Realistic Medicine, published in 2016.

Realistic medicine, the report explains, “puts the person receiving health and care at the centre of decision-making and encourages a personalised approach to their care. Its aims of reducing harm and waste, tackling unwarranted variation in care, managing clinical risk, and innovating to improve, are essential to a well-functioning and sustainable NHS.”

It is hoped the approach will be adopted by all healthcare providers by 2025. The report defines “realistic” as: “having or showing a sensible and practical idea of what can be achieved or expected; and representing things in a way that is accurate and true to life.”

Dr Calderwood’s 2016 report was broadly welcomed by healthcare professionals and widely shared on social media, reaching almost 10 million Twitter feeds a year after publication. She now hopes to build on this initial success by engaging with healthcare providers and patients to realise her vision.

Dr Calderwood said: “I have been told many times that the approach in Realistic Medicine is ‘the right thing to do’ and I hope that by championing this as the Chief Medical Officer for Scotland, clinicians feel that they have greater latitude to practise in this way.”

She added that clinicians can only practise “realistically” with the full understanding and support of patients.

Realising Realistic Medicine includes a message for them, stating that: “You should expect the doctor (or other health professional) to explore and understand what matters to you personally and what your goals are, to explain to you the possible treatments or interventions available with a realistic explanation of their potential benefits and risks for you as an individual, and to discuss the option and implications of doing nothing.

“You should expect to be given enough information and time to make up your mind. You should consider carefully the value to you of anything that is being proposed whether it be a treatment, consultation or diagnostic investigation and be prepared to offer challenge if you feel it appropriate.”

BMA Scotland chair Dr Peter Bennie welcomed the report but said doctors were concerned they do not have enough time to adopt some of the proposed innovations.

He said: “Doctors want and expect to be innovators and leaders in improving outcomes for patients, however to do this well we need time to learn, teach and reflect. We need to have an honest and open debate with the public and politicians about what the NHS can realistically provide.”

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