One of the main aims of Realistic Medicine is for people using healthcare services and their families to feel empowered to discuss their treatment fully with healthcare professionals, including the possibility that a suggested treatment might come with side effects – or even negative outcomes. Everyone should feel able to ask their healthcare professional why they’ve suggested a test, treatment or procedure, and all decisions about a person’s care should be made jointly between the individual and their healthcare team.
Realistic Medicine is not about failing to offer treatments. It is about supporting people using healthcare services, and their families, to feel empowered to discuss their treatment. That’s why changing our style to sharing decisions with our patients is one of our priorities. A move away from the "Doctor knows best" approach to shared decision making between the professional and patient will require more meaningful discussions about the treatment options available as well as their risks and benefits.
Building a more personalised approach to care, in partnership with people through shared decision making, is perhaps the most important aim of Realistic Medicine. We must create a more open and trusting atmosphere that facilitates more meaningful conversations between people and their healthcare professionals that help people make informed choices about their treatment and care options, based on what matters most to them.
Healthcare professionals are the stewards of healthcare resources. We know that overuse of investigation and treatment can result in harm to patients. By seeking out and eliminating harm and waste, we can provide healthcare that people really value.
Tackling unwarranted variation is essential to improving outcomes derived from healthcare across Scotland. Unwarranted variation is variation in healthcare that cannot be explained by need, or by explicit patient or population preferences. We need to ensure the prevention of harm and waste from overuse and overtreatment, freeing up resources currently used without benefit to clinical outcomes in order to address under-provision of care.
Realistic Medicine is not about failing to offer treatments. It is about supporting people using healthcare services, and their families, to feel empowered to discuss their treatment.
To practise Realistic Medicine, we must embrace the best international evidence, employ sound clinical judgment and support empowerment by listening to what matters most to patients. We need to make more effective use of knowledge and skills across the multi-professional knowledge base, and foster the conditions to support innovation in care delivery.
June 24, 2022
Earlier this year I contributed to a Realistic Medicine symposium organised by colleagues at National Services Scotland. One of my themes was that the principles of Realistic Medicine and shared decision making should not be regarded as optional add-ons for clinicians interested in the area, but were completely embedded in the current law on consent….Read more
February 15, 2022
I am going to begin with a quote made popular by the magnificent Maya Angelou “People will forget what you said, people will forget what you did, but people will never forget how you made them feel”. I’m sure that you can relate to this quote, we all can both in our personal and professional…Read more
December 22, 2021
Within NHS Tayside I am Associate Medical Lead for Quality Management, and Clinical Lead for Realistic Medicine. In our health board, a key Realistic Medicine project has commenced to test ReSPECT (Recommended Summary Plan for Emergency Care and Treatment), which is a process that involves a conversation between patients and healthcare staff to create individualised…Read more
November 22, 2021
What matters most to me when I am feeling stressed or under pressure, is the ability to escape into the countryside to exercise. Gyms and treadmills do not work – it must be the open air, seeing, enjoying and experiencing nature. I am fortunate to have hills to climb, trails to run and great cycle…Read more
November 8, 2021
In Forth Valley, we are always looking for new and interesting ways to share Realistic Medicine and build our Realistic Medicine network. Just like everyone else, we have had to think differently about how we do this in the post-pandemic era. Inspired by Kaleidoscope, a health and care consultancy , we embarked on a series…Read more
October 12, 2021
The pandemic created an understandable feeling of fear and uncertainty across NHS Scotland staff while all areas prepared for the unknown. NHSWI was no different to any other area in this regard. Being on an island chain the ability to meet had always been an issue both within primary care and across the primary/secondary care…Read more
October 19, 2021
The National Demand Optimisation Group (NDOG) has presented their Phase IV Report, which was published on the Scottish Government website on 11 October 2021. The Scottish Government has funded the National Demand Optimisation Group (NDOG) since its establishment in 2016, under the auspices of the Healthcare Science National Delivery Plan (NDP). The objective of the…Read more
November 9, 2021
The NHS Lanarkshire ‘Realistic Medicine: Back to the Future’ conference will take place on Thursday 25 November from 9.30am to 4pm. The conference will be delivered by both attendance and virtually via Microsoft Teams. Attendance in person will be limited to 20 places. To book a place, please email LQA.RealisticMedicineTraining@lanarkshire.scot.nhs.uk The conference is open to…Read more