Evidence 2010 and minimally disruptive medicine

By Victor Montori

On November 1 and 2nd, clinicians, policymakers, and methodologists got together at the BMA House in London, UK for the Evidence 2010 meeting.  The BMJ and Oxford’s Center for Evidence-based Medicine convened the meeting and it was a major success.

I had the opportunity to participate as a keynote speaker opening day 2.  While I can summarize my presentation (the content and slides are elsewhere on this site), the colorful summary published in the BMJ does a much better job.  You can read it here.  The key paragraphs follow:

His strategy combines better explanations to patients of the benefits they may be missing, and giving them a chance to “choose their own poison” by taking them through the treatment options in a gentle conversation. A patient who has been given a choice is more likely to adhere to the treatment, whatever is chosen, he believes.

He also believes in “minimally disruptive medicine,” trying to devise a strategy that does not leave the patient spending hours each day organising his pills, arranging tests and appointments, and worrying about his disease. For a diabetic patient with multiple co-morbidities, doing this can turn into “a part time job” Dr Montori said.

Language needs to be changed, too. “LDL cholesterol is not a word” he asserted. “I have to talk to my patients about living longer, feeling better, and living unhindered by the complications of the disease. If I can’t do that, I shouldn’t be treating them.”

I am grateful to my colleagues at CEBM and BMJ for the invitation and I look forward to Evidence 2011.  I will post an update here when the organizers post the video of the presentation online.

 

 

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One thought on “Evidence 2010 and minimally disruptive medicine

  1. “Language needs to be changed, too.”
    One must use terminology that enables patients to make informed, rational decisions. While at a meeting last summer with a gastro practice, we were discussing low colorectal screening adherence rates. I told them how to attempt to solve it – start focusing on communicating to the patients the colon cancer prevention aspect and not the procedure aspect of screening – the uncomfortable colonoscopy. If people understand the probability of getting CRC decreases ~60-90% with colonoscopy and polypectomy, they will focus on that instead of the miserable prep. At least that is what I hope they would do.

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