Can We Choose Wisely?

Dr Ramai Santhirapala is an Honorary Consultant in Anaesthesia and Perioperative Medicine at Royal Surrey County Hospital and a Clinical Advisor at the Academy of Medical Royal Colleges. In the latter role she advises on the international programme ‘Choosing Wisely’, which aims to improve conversations between healthcare providers and patients. Dr Santhirapala’s specialist interests are shared decision making and end of life care, believing patients should lie at the heart of healthcare decisions. She has published in the British Journal of Anaesthesia and Perioperative Medicine and is undertaking research into educational needs for physicians to practice shared decision making. She tweets at @ramai23

choosing-wisely_2Shared decision making (SDM) is increasingly synonymous with healthcare, moving away from paternalism towards a balanced approach to decision making involving both patients and clinicians. What exactly is SDM? That is the ubiquitous question to which there is currently no universally agreed answer. The King’s Fund intimates a definition pointing out SDM is a process during which patients and physicians use evidence based information to support the deliberation process based on patients’ values, beliefs and preferences. This highlights that a physician is still expected to bring clinical expertise, whilst a patient brings expertise on what matters to them. Continue reading

Making it happen! An Acute Clinical Team in action

Firdaus Adenwalla is a consultant geriatrician in ABM University Health Board.  He is part of the Neath Port Talbot Acute Clinical Team providing an intermediate care service for the community. 

The media reminds us daily of how our health service is not keeping pace with our changing world. The negativity around health care, hospitals overflowing, not enough doctors, not enough nurses, GP practices closing, and the list goes on. Increasing demand, improved technology and our increased life expectancy, all compound the notion that our health service cannot meet our needs. Continue reading

Can doing nothing sometimes be the best approach?

cwDr Amit Arora is a Consultant Physician and Geriatrician at University Hospital of North Staffordshire, Stoke on Trent and an Honorary Clinical Lecturer at Keele University.

You may have seen recent stories in the national media about a new campaign launched by the Academy of Medical Royal Colleges called Choosing Wisely. It says that patients should be encouraged to ask if tests are really needed, that doctors should discuss potential harms of treatment with patients, and calls for experts to develop lists of common practices that should be stopped.

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