A national discussion on unnecessary care #ChoosingWisely #Canada

I am sharing this in case it has not made the rounds. The Canadian Institute for Health Information (CIHI)/Choosing Wisely Canada (CWC) report, Unnecessary Care in Canada, should be available in April. In the meantime you can read briefly about CIHI's role with CWChere.

(Original post)


A National Discussion: Unnecessary Care in Canada

The Canadian Institute for Health Information (CIHI) and Choosing Wisely Canada (CWC) invite you to join us for a discussion on the extent of unnecessary care in Canada.

This webinar will introduce a new CIHI/CWC report, Unnecessary Care in Canada, and facilitate a conversation about the magnitude of and variation in unnecessary care across several areas covered by CWC’s recommendations.

The event will include

  • A moderated panel discussion with:
    • David O’Toole, President and CEO, CIHI;
    • Dr. Wendy Levinson, Chair and Co-Founder, CWC; and
    • Dr. Laurent Marcoux, President-Elect, Canadian Medical Association
  • Speakers from the Canadian Partnership Against Cancer, North York General Hospital and other organizations, who will share their success stories about addressing unnecessary care
  • Q & A session

Date: April 6, 2017
Time: 9 to 10:30 a.m. ET

Please note that this webinar will be conducted in English only and will use Eastern Time. To accommodate multiple time zones, a recorded copy of the webinar will be made available. When you register, please specify if you would like the recorded version.

Registration: To participate, you must have access to the internet, as well as speakers/headphones. The webinar will be accessible on iOS and Android devices (both mobile phones and tablets).

To register for the webinar, please email Alison Clement at aclement@cihi.ca

CONFERENCE: Hellish Decisions in Healthcare Jan 2017

Hellish Decisions in Healthcare is designed as a space for healthcare leaders, professionals and researchers within the international healthcare community to shape healthcare policy and systems to deliver Triple Value.

  • Personalised value, the delivery of services informed by what matters to the individual

  • Technical value, determined by how well resources are used within services for each purpose

  • Allocative value, determined by how the assets are allocated to services for different purposes.

The decisions and strategies needed to deliver Triple Value will not always be immediately apparent and nor will they be easy to make; the Value in Healthcare Forum is a safe place where these strategies can be developed and where strategic discussions can be had with the key thought and implementation leaders in healthcare.

Read more on the website and do Register by Oct 15 for the Early-Bird Discount.  The event will be in Oxford, Jan 12 to 13th, 2017.


For more events related to "Less is More," "Choosing Wisely," "Preventing Overdiagnosis," "Shared Decision-Making," etc, go here.

 

Source: https://www.phc.ox.ac.uk/events/hellish-de...

Minimally disruptive medicine: Effective Care that Fits Workshop SEPT 2016

I read the fantastic Minimally Disruptive Medicine (MDM) Blog and want to bring your attention to the Mayo Clinic KER Unit MDM event, coming soon:

From the MDM site:

Click on the image to find out more about the Minimally Disruptive Medicine Workshop.

Minimally disruptive medicine (MDM) seeks to advance patient goals for health, health care, and life, using effective care programs designed and implemented in a manner that respects the capacity of patients and caregivers and minimizes the burden of treatment – the healthcare footprint – the care program imposes on their lives.

This site is maintained by researchers at the KER UNIT who are part of an international research team that is working on understanding and implementing MDM across the world.

Some introductions to MDM:
From the peer-reviewed press
From the medical press
From the lay press
From Wikipedia
From a presentation (video) 
From a radio interview (audio)
Complexity Care Model article

 


For more events related to "Less is More," "Choosing Wisely," "Preventing Overdiagnosis," "Shared Decision-Making," etc, go here.

Quality Forum: A New Kind of Rounds (Teaching patient-centred care that avoids unnecessary and harmful interventions)

I have followed the Do No Harm project and their articles in JAMA's Teachable Moments section (under the Less is More theme). Then, at the Lown Institute's Road to Right Care conference, I learned more about "Right Care Rounds," and in Nanaimo we developed our own version.

More background information and the talk from our first session, on the subject of treatment of Type 2 Diabetes in the elderly, can be found here.

Following the success of this event, we decided to do more of them. Our next one is tentatively in April and will be on the subject of overtreatment of hypertension. Thinking, "why not spread the message of what we are trying?," we've created a poster that I will present at the BC Quality Forum.

You can view the full poster 'storyboard' by clicking the image below.
 

ATTN: Edmonton, Feb 3, 2016 Picard Lecture: Less Medicine, More Health: 7 Assumptions That Drive Too Much Medical Care

Gilbert Welch (img used without permission,  Beacon Broadside )

Gilbert Welch (img used without permission, Beacon Broadside)

I just learned of this event in Edmonton, on Feb 3rd. Don't miss it!

Welch is a persuasive champion of 'less is more' in medicine, and his talks are inspiring, dynamic, and necessary. If you can't attend, check out his latest book, Less Medicine, More Health. RSVP details below. - J.


From The University of Alberta (original post):

"Many doctors are worried about the problems caused by too much medical care. A recent survey suggested that nearly one-half said their patients received too much medical care. But it is hard to communicate the nuances – that medical care can do a lot of good in selected settings, but can also do harm in others – during a 10-15 minute clinic visit.

Doctors like to blame lawyers for the problem of too much medical care. But ask yourself this: Would the problem of overuse disappear if the lawyers disappeared? Economists like to blame economics. But the recipe of adding fee for service to third-party payment to cook up too much medical care would not work without strong underlying beliefs about the value of the product. The general public harbors assumptions about medical care that encourage overuse.

I’m not blaming the public; many of these assumptions flow directly from information provided to them – be it from the news media, talk shows, advertising, PR campaigns, disease advocacy groups, public service announcements or doctors themselves.

Regardless of their source, these assumptions lead individuals to have an excessively optimistic view of medical care. That leads them to seek – some would say to demand, others to accept – too much care.

February 3, 2016
12:00
McLennan Ross Hall (Rm 231/237), Law Centre (111 - 89 Ave)
University of Alberta - Edmonton, AB

Please RSVP here.

Dr. Welch is a general internist and professor of Medicine at the Dartmouth Institute for Health Policy and Clinical Research in the Geisel School of Medicine. He is also a professor of Public Policy at Dartmouth College and a professor of Business Administration at the Amos Tuck School.

For the 25 years he has been practicing medicine, Dr. Welch has been asking hard questions about his profession. His arguments are frequently counter-intuitive, even heretical, yet have regularly appeared in the country's most prestigious medical journals — Annals of Internal Medicine, Journal of the American Medical Association, the New England Journal of Medicine and the Journal of the National Cancer Institute — as well as in op-eds in the Los Angeles Times and the New York Times. His most recent book is Less Medicine, More Health – 7 Assumptions that Drive Too Much Medical Care.

Dr. Welch is very much part of the “Dartmouth School” that questions the assumption that more medical care is always better. His research has focused on the assumption as it relates to diagnosis: that the best strategy to keep people healthy is early diagnosis – and the earlier the better. He has delineated the side-effects of this strategy: physicians test too often, treat too aggressively and tell too many people that they are sick. Much of his work has focused on overdiagnosis in cancer screening: in particular, screening for melanoma, thyroid, lung, breast and prostate cancer."

It's #PODC2015 time: Preventing Overdiagnosis 2015 is here

After an incredible General Council (the annual meeting of the Canadian Medical Association), it is now time for me to zip off to Bethesda, MD for Preventing Overdiagnosis.

Although I attended last year in Oxford, this will be my first time speaking at the conference; I have the fortune of working with Dr James Rickert (who challenges conflict of interest in orthopedics and puts the patient first) in order to present a workshop around some of the criticisms (and related solutions) for the Choosing Wisely campaign (at 11:30, Weds Sept 2nd).

I would say that I am Choosing Wisely's biggest fan, and biggest critic. I am looking forward to the opportunity to hear more thought from my peers about the campaign and what the next steps might entail. There is so much hope and opportunity with this initiative and it's a great time to strengthen it and to reach higher!

This conference will also be a great opportunity to reflect on the past couple of years and the progress that so many people have made, and to meet up with colleagues to hear about their planned work going forward. There will be quite a few curious and critical-thinking Canadians in attendance, including (I hear):

-   Dr. Laurent Marcoux (former head of the Quebec Medical Association, one of the key developers of their Action Plan for Overdiagnosis

-    Dr. Roland Grad (researcher in family practice currently looking at harnessing infoPOEMs to identify low-value tests and treatments)

-    Dr. Rita McCracken (finishing her PhD, an expert on polypharmacy/deprescribing in the elderly)

-    Dr. Tracy Monk (humble yet highly effective champion and practicer of patient centered, evidence-based, and relationship-based care)

-    Dr Alan Cassels (co-author of Selling Sickness and highly sensible drug policy researcher)

-    Joanna Trimble (family member and advocate for confronting polypharmacy and sedative overuse in the elderly, at Is Your Mom On Drugs?)

-    Dr. Danielle Martin (head of Canadian Doctors for Medicare and outspoken advocate for doing more with less)

-    Dr Sacha Bhatia (chair of evaluation and can-do pioneer for Choosing Wisely Canada)

-    Dr Jennifer Young (leader of the Don’t Just Do Something, Stand There workshop with the Ontario College of Family Practitioners)

Go Canada!

And that is just the tip of the iceberg. The entire conference will be comprised of like-minded peers from around the world. I can't wait to get started tomorrow; see you there!!!

 

See you Monday at: Preventing Overdiagnosis Conference #PODC2014

I'm off to the Preventing Overdiagnosis Conference in Oxford, UK. It starts on Monday. It's the first time I'll be at a large gathering of people who are all interested or active in the area of overdiagnosis / less is more medicine / appropriateness in health care / prudent medicine / minimally-disruptive medicine or whatever you call it!

I'll get to meet and hear talks from a few important people in this movement, including Drs Margaret McCartney, Iona Heath (who I had the pleasure of meeting in Vancouver when she spoke here), Fiona Godlee, and Paul Glasziou. I believe representatives from the QMA will also be there to talk about their Action Plan for overdiagnosis.

Without exception those presenting are passionate thinkers; I'll meet many like-minded individuals, learn about all kinds of remarkable efforts, and do my best to share the highlights here.

See you there!