Why a realistic approach to health and social care is best for patients
When facing illness, too often people aren’t given enough information about what care they receive and what other options might be on the table. We need to do more to put the person at the centre of their own care, taking into account their priorities and how they want to live.
It’s natural to chase the chance for a cure through a particular treatment when we get ill, however small that chance might be. But there isn’t always one right answer. Although one option might be right for one person, it could be the wrong choice for someone else.
Having the chance to review the options properly, and get the care that’s right for us is a really important part of all health care. But it’s especially poignant in palliative and end of life care.
It’s telling that most doctors say they wouldn’t choose the aggressive treatments they prescribe to their palliative patients for themselves. So what can be done to make sure patients have a clearer picture of what their options are?
Being clear and reasonable about what’s possible
This is where Realistic Medicine – a concept for revising the way we approach health and social care in Scotland – comes in.
The approach aims to put the person at the centre of their own care, taking into account their priorities and how they want to live. It’s about having 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.
The ideas behind Realistic Medicine have been developed by Scotland’s Chief Medical Officer, Dr Catherine Calderwood.
Spreading the word about Realistic Medicine
The sad truth is that many people, including those with a terminal illness, do not get this opportunity to be at the centre of their own care choices.
Harry Bunch cared for his wife, Liz, through her terminal illness. He described his situation as like receiving a jigsaw puzzle, but without the aid of the picture or knowing if he had all the pieces of the puzzle.
Fixing this is not just about educating health care professionals and changing processes – but also informing the public, who need to be empowered and supported to have their say.
Dr Catherine Calderwood’s agenda has become one of the biggest talking and discussion points in Scottish health and social care since she published her Annual Report on Realistic Medicine , and followed it up last year with Realising Realistic Medicine .
She argues that an approach to health and social care which has the principles of Realistic Medicine at its heart will help inform and engage people about what care they receive and alternate options, where that is possible.
Dr Calderwood also hopes it will also reduce harm and risk, reduce variation and help the NHS run sustainably.
What’s standing in the way of progress?
The biggest challenge to realising the Realistic Medicine agenda is the need for investment in services and staff.
We may be able to reach a point where everyone believes in the realistic medicine agenda. Patients, families and practitioners may all agree to an approach of shared decision-making.
But without the investment in services that we need to see, turning this willingness into reality will be very difficult.
Dr Catherine Calderwood spoke at a Marie Curie Scotland event on Thursday 14 September in Edinburgh, addressing an audience of over 80 health and social care professionals. Read her latest report to find out more about Realising Realistic Medicine .