The number of new drugs being developed and the demands of people for better health continue to increase. However, this should not be a reason to overtreat patients. In fact, Scotland's chief medical officer urges clinicians to prescribe fewer medicines.

In Dr. Catherine Calderwood's first annual report on the country's state of health, she says overtreatment is a serious concern especially in the time of limited budget. Fewer treatments may actually result in more improved quality of life for some people, she says.

At present, the trend is to address risks instead of existing symptoms. While this may result in improved condition such as in gestational diabetes, it may also lead to a rise in patients being given more harmful treatments such as in low-risk prostate cancer or taking drugs and undergoing diagnostic tests for conditions that may not actually exist.

The aging population in particular has increasingly complex needs, which may contribute to Scots taking massive volumes of medicines each year. According to statistics, about 20 percent of adults take more than five drugs daily.

Calderwood's solution in mind is to ditch the "doctors know best" approach.

"Doctors often fail to take into consideration patient preferences in suggesting and providing treatment," the report reads.

The report adds that clinicians should acknowledge their powerlessness at times. They must also ensure that a letdown on their part in accepting the inevitable does not thoroughly affect the patient's experience of death.

Calderwood says it is time to give way to realistic medicine, which allows patients to be fully engaged in the entire care process. She notes, however, that this would only be possible if patients are willing to have this level of discussions with their doctors.

Dr. Brian Robson, the executive clinical director of Healthcare Improvement Scotland, says Calderwood is right to say that patients and their families are at the core of their own care. He also says that the report contains the new skills, attitudes and behaviors that doctors nowadays must posses. For this, he describes the report as a "must-read" for clinicians.

The government of Scotland has presented its vision for the year 2020 to provide longer and healthier lives for all Scots in the home setting. In line with this, officials are working together to provide safe, effective and personalized care to all people. To achieve this, all doctors must be empowered to instigate changes according to how the government designs and delivers care to those who avail of its services.

Photo : Kiran Foster | Flickr

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