Scotland’s Chief Medical Officer has used her first annual report to call for a debate among doctors on the subject of realistic medicine.
Dr Catherine Calderwood is encouraging medics to further involve and discuss with their patients what is important for them as individuals – which may be deciding not to have treatment. She asks doctors to question variation in practice and outcomes, to reduce waste and encourages innovative ideas and research to improve medicine for the future.
She writes that increases in available medicines and treatments and public pressure and expectations, combined with greater numbers of people living longer with multiple conditions, can sometimes lead to over-treatment which is of little long-term benefit to the patient. She calls for greater transparency in decision making.
Dr Calderwood, an obstetrician and gynaecologist, will launch the report this morning at Edinburgh’s Western General Hospital. She will meet doctors to discuss the report, as she kicks off a conversation with the medical profession about how they see the future of the health service.
The report also carries a summary of data on the health of the nation, featuring previously published statistics about indicators such as obesity, cancer mortality and smoking rates.
Dr Calderwood said:
“Doctors are doing a tremendous job up and down the country, serving their patients with distinction, and learning to adapt in the face of the changing demands being put on the health service. It’s vital that medicine constantly evolves, and the challenge to us as doctors is to ask ourselves how we can change our own working practices to create even better outcomes for patients.
“In striving to provide relief from discomfort, illness and death, modern medicine can sometimes over-reach itself and provide treatment that is of little long-term benefit to the patient. This is especially true when a person has multiple conditions, each of which has its own list of recommended medicines and treatments.
“Realistic medicine is about moving away from the ‘doctor knows best’ culture. It’s about more fully involving patients in the decisions about their care. Of course this will only happen if people are prepared to have these conversations in this way with their doctors.
“It’s an interesting fact that doctors tend to choose fewer treatments for themselves than they offer to their patients. As doctors we should be asking why that is, and whether patients – if better informed – might also choose less intensive and less medicated treatment regimes. A person may achieve a greater quality of their life if less is done - fewer treatments, more targeted medication.
“Doctors and other health care professionals are experts in our NHS – in these challenging times I want to hear from them how we can best practice medicine in NHS Scotland and beyond- how to innovate, ask questions about variation in practice and outcomes, reduce waste and act differently to improve care.
“I will be speaking to doctors over the next few months to ask them what they think about these issues in our rapidly evolving health service. I hope to engage the profession in a dialogue about where we are going, and what role doctors can play in shaping the future of the NHS.”
Source: Scottish Government