Family Physician, “Broker of Choices”

Canadian Family Physician, in an article about how the future will bring both challenges and opportunities for family physicians, uses the term “broker of choices”. I thought this was a poignant way of describing what I find myself doing more and more.

“With strong skills in patient-centred care, including evidence-based decision support, and our core valuing of relationships, we will be well positioned to address the emerging focus on the potential harms of overscreening, overdiagnosing, and consequently over-treating, as well as iatrogenic harm. As an evidence-based lens increasingly requires reporting on harms and consideration of unreported negative randomized controlled trials, many of our screening, diagnostic, and treatment approaches are being more closely scrutinized. Termed “minimally disruptive medicine,” an approach to patient-centred care is emerging in which the burden of treatment is emphasized as an important component of the overall burden of illness. As we move forward and find ourselves managing increasingly older, more complex patients with chronic diseases, it will be imperative, in terms of both minimizing harm and nurturing a trusting patient-doctor relationship, to consider the risks posed by overburdening our patients with tests and treatments that are unlikely to lead to what they, within their individual contexts, determine to be meaningful outcomes. As such shifts in paradigm take place, family medicine’s grounding in patient-centred care will help our discipline remain a strong contributor to the health of our patients.”

http://www.cfp.ca/content/60/5/409.full

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