All health professionals should practice ‘realistic medicine’ by 2025, says CMO

All healthcare professionals in Scotland should adopt a personalised approach to their care by 2025, Scotland’s Chief Medical Officer (CMO) Catherine Calderwood has said.

Her second annual report, ‘Realising Realistic Medicine’, published today, seeks to embed her realistic medicine philosophy in all health and social care services.

This will mean moving away from a culture where ‘doctor knows best’ to one where people receiving care are more informed and part of the decision-making process.

This would cut down on waste and “over prescribing”, according to the CMO.

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"By 2025, everyone who provides healthcare in Scotland will demonstrate their professionalism through the approaches, behaviours and attitudes of Realistic Medicine," the report said.

As the population gets older, the changing face of disease and care means doctors and other professionals are increasingly looking at managing symptoms as opposed to seeking a cure, and this has changed the nature of conversations with those they treat.

Calderwood said her own conversations with clinicians following last year’s report had shaped this year’s follow-up.

“When I published my first annual report, I couldn’t have anticipated that it would ignite such a broad and enthusiastic discussion around the six key questions I asked about realistic medicine,” she said.

“These conversations have been of enormous benefit in helping to shape thinking as we embark on translating the realistic medicine philosophy into actions that justify that interest and enthusiasm.”

Public engagement in the concept of realistic medicine takes place through the ‘Our Voice’ project, run by the Scottish Health Council and the Health and Social Care Alliance Scotland.

Alliance chief executive Ian Welsh said: “It is more crucial now that people who access health and social care are engaged as equal partners in this process alongside Scotland’s clinical and care professionals.

“We therefore look forward to working with the Chief Medical Officer and the Scottish Health Council to engage with the public to help establish what realistic medicine means to them.”

The British Medical Association in Scotland welcomed the CMO’s report but said increasing demand and high levels of long term vacancies meant many doctors had little time to be the “innovators and leaders” they wanted to be.

Chair Dr Peter Bennie said: “We need to have an honest and open debate with the public and politicians about what the NHS can realistically provide.”

In her summary of the health of the nation, Calderwood also said obesity, physical inactivity and alcohol-related harm remain Scotland’s key public health challenges.