BIG NEWS! QMA Unveils Action Plan for Overdiagnosis, Cost Savings

The Quebec Medical Association (QMA) just unveiled an Action Plan around Overdiagnosis!!

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This is an exciting day in "Less is More" !! This is a tangible and significant step forward towards making sure our patients get the right care.

Here is the hope- and awe- inspiring release, from the QMA


MONTREAL, Aug. 18, 2014 - The Québec Medical Association (QMA) is embarking on a new phase today in its effort to tackle the issue of overdiagnosis by unveiling an action plan that would allow major health budget savings. The plan is a result of concerted action between the main stakeholders in the health care system - physicians, representatives of medical and professional associations, the Collège des médecins du Québec and other professional orders, regional agencies and patient advocacy groups - subsequent to the first Québec Symposium on Overdiagnosis.

Following the release of this action plan, the QMA requested a meeting with the Minister of Health and Social Services, Dr. Gaétan Barrette, in order to coordinate the efforts to be deployed over the next few years to reach the expected results.

This action plan is the culmination of a process started in April 2013 with the publication of a discussion paper in which the QMA addressed the urgent need to optimize clinical practice in order to redirect approximately $5 billion to those activities that are most useful and relevant to patients. The goal of the action plan released today is to guide the actions that will be taken to reduce and prevent overdiagnosis. It presents the main orientations and potential solutions.

The issue of overdiagnosis generated considerable interest among the general public and health care stakeholders at the symposium and the launch of the Choisir avec soin campaign last April. The latest newsstand version of L'Actualité focuses on this priority issue for the Québec health care system.

Because overdiagnosis is a global phenomenon, the QMA's initiatives are also stirring international interest. At the suggestion of the well-known British Medical Journal, the QMA will give an account of its work and achievements in this area at the second international conference on the prevention of overdiagnosis in Oxford, England, in a few weeks. At the request of European government agencies/EU paying agents, the QMA will present the results of its efforts in November.

"Overdiagnosis greatly impacts the quality and accessibility of the health care offered to patients, and as a result, the efficiency of the entire health care system," stated QMA President Dr. Laurent Marcoux. "This problem has become a priority and we can no longer ignore it."

It will be exciting for me to meet the QMA representatives at the Preventing Overdiagnosis conference in Oxford this Sept and you can bet your bippy I'll be discussing this in BC with my Doctors of BC colleagues!

Viser Juste: Shoot Straight (kind of)


It's tough to translate. Viser Juste. Not exactly "Shoot Straight" or "Get it Right," it's really about getting as close to the target as we can, hitting that bull's eye. In this case, hitting the sweet spot of 'Right Care.' Not too much or too little.

Training together during Family Practice Residency in Nanaimo, Simon-Pierre Landry and I shared a few things: an appreciation for the kind of jaded medical humour and cynicism in The House of God, love of the hits of the 90s, an eagerness to debate the fundamentals of Canadian culture, and a taste for fancy cheese. We both also had a curiousity about why we practice medicine the way we do and how we can do it better.

"Laws of the House of God, #13:  The delivery of good medical care is to do as much nothing as possible." — Samuel Shem, House of God

Dr Landry is now an Emergency Physician and Intensivist in Sainte-Agathe-des-Monts, QC. He writes a regular Méditorial column for Santé, a publication of the Canadian Medical Association. He interviewed me while I was in Yellowknife for part of his article about Appropriateness in Medicine.

In Viser Juste, Dr Landry brilliantly weaves together House of God, the Choosing Wisely (Canada) campaign, and Ken Murray's How Doctors Die to make the case for a "Less is More" approach to medicine.

As physicians, we know that advances in medical technology are undeniable progress. At the same time, we also understand that these technological advances are not without flaws, and the possible consequences must be analyzed by an objective expert who is skilled at dissecting complex situations, for example, the clinician. We also understand that these technologies have a cost and do not always offer value for money. Sometimes, investing in other types of medical care or improving the social determinants of health (eg. guaranteed minimum income, early childhood services, mold-free schools) would be a wiser use of public funds. (translated roughly by Google & I)

Read a translated version of the Viser Juste ["Shoot Straight"] article (in Google Translated English-ish).

Read the Viser Juste article (in French) and don't miss Dr Landry's other articles at Santé Inc.