Realistic Medicine needs exposure within the clinical environment to ensure the concepts are endorsed by the multidisciplinary team.
What have we done so far?
Awareness-raising has been key. The Realistic Medicine infographic and report was discussed in local district clinical meetings, the area clinical forum and in board committee meetings such as GP subcommittees, Area Medical committee and others. An article in NHS Highland 'Highlights' staff newspaper was published and Realistic Medicine was presented as a 'news' item on the NHS Highland intranet.
The Area Clinical Forum is an area of specific interest and it has taken responsibility for each of its subcommittees to present a work plan related to the themes of 'Realistic Medicine', for example the Area Ophthalmic committee proposes to develop and embed guidance and protocols for local optometrists regarding referral to ophthalmology. This relates to the 'reducing variation' and 'reducing waste and harm' themes. Members of the Area Clinical Forum have been asked to discuss the individual implications of work undertaken.
It is essential to involve the public and for 'what is realistic for me?' to become part of the philosophy taken when considering care. Implementation of the Realistic Medicine oversight group will include clinicians from a variety of specialties. Plans to embed the Realistic Medicine culture include using reminders or checklists in consultations to ask the clinician - are you working realistically? Raising awareness still needs to occur before work undertaken can be truly effective.
We need to practice 'Realistic not Nihilistic Medicine'. Realistic Medicine in NHS Highland is not about cost-saving, it is about improving the way that we all practice in order to better involve patients in care that is safe and individualised.
Email: Catherine Calderwood