Wednesday, February 19, 2014, 1:00 pm ET/10:00 am PT
Topic: Minimally Disruptive Medicine
Guest: Victor Montori
Minimally Disruptive Medicine (pdf)
Physicians sometimes wonder, "Why don’t my patients follow the instructions I give them?” Patients sometimes wonder why their physician can’t just give them a quick treatment that will make them well. But chronic disease is the epidemic of our times, and usually requires lifetime management. Much of that management must be done by the patient, who will need to find a way to fit medical and lab appointments, exercise, medications and dietary changes, into a life already busy with family and work.
Victor Montori, a professor of medicine at Mayo Clinic, Carl May, a professor of medical sociology at Newcastle University and Francis Mair, a professor of primary care research at University of Glasgow, decided to explore this issue, the burden of treatment, by learning from patients, especially the patients with multiple chronic comorbidities or cognitive impairment—two groups that are often excluded from studies examining adherence. Among those they talked with were a man who in the previous two years had visited specialist clinics for appointments, tests and treatment 54 times, the equivalent of a full day every two weeks. They discovered a woman whose doctors had prescribed medications to be taken at 11 separate times during the day, and she was having trouble managing this.
From this experience they began developing principles for "minimally disruptive medicine.” You can learn more from a blog on the topic, a WSJ interview with Dr. Montori, or this musical (and factual) version.
Victor M. Montori, MDis a Professor of Medicine at Mayo Clinic. An endocrinologist and health services researcher, Dr. Montori is the author of more than 400 peer-reviewed publications and editor of 2 books of evidence-based endocrinology. He is member of the National Advisory Council of the Agency for Healthcare Research and Quality, the Editorial Advisory Board for the BMJ, and Director of Community Engagement in Research at the Mayo Center for Clinical and Translational Science. He is a recognized expert in evidence-based medicine and shared decision making, and developer of the concept of minimally disruptive medicine. He works in Rochester, Minnesota, at Mayo Clinic's KER Unit, to advance person-centered care for patients with diabetes and other chronic conditions.