What kind of things are included in realistic medicine?
●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
What conditions do we most commonly see overdiagnoisis?
Prostate and thyroid cancers
chronic kidney disease,
attention deficit hyperactivity disorder
What is the consequence of over diagnosis?
Medical, social and economic consequences follow
What are the consequences of reducing diagnostic hypertension blood pressure?
Lots of 'healthy' individuals become patients
Exposed to drug induced problems such as kidney injury relating to Ace Inhibitor or diuretic use
Ankle swelling or flushing assocaited with calcium channel blocker use
Bradycardia, lethargy or erectile dysfunction assocaited with beta blockers
Change in insurance and mortgages
Now have contraindictations to some drugs such as NSAIDs
Worry of being at a higher risk of stroke
Give an example of a quality monitoring group
Scottish Intensive Care Society Audit Group