Getting patients more involved in healthcare

Report calls for a move away from ‘doctor knows best’ culture

Patients are being encouraged to get more involved in healthcare decisions to avoid unnecessary treatments.

Scotland’s chief medical officer has called for a wider conversation about a move away from the “doctor knows best” culture.

Dr Catherine Calderwood’s latest annual report builds on her first on “realistic medicine”, which aims to more fully involve patients in decisions about their care as well as reduce harm and waste in the system.

A citizens’ jury and panel will be used to gauge public views on the concept and the changes they want to see in health and care.

Dr Calderwood told BBC Radio Scotland’s Good Morning Scotland programme: “We know from research that doctors, particularly at the end of life, would choose different treatments, perhaps less intervention, less medication, than they would offer to their patients and I wanted really to try to understand that disconnect.

“Why would we be doing something different to what we would talk to our patients about?

“I’ve really started to ask this question – what are the priorities for people?

“And in fact, particularly with a terminal diagnosis, most people do not necessarily want to live longer, they actually want to be symptom free, and they particularly want to spend time with their families.”

Dr Calderwood acknowledged the approach would require “honest conversations”, particularly for patients with a terminal condition.

She said: “This is about more information. My second report published today will have a real public focus.

“We are having a citizens’ panel, a citizens’ jury, much more information for the public, for patients and for their families to be able to have these conversations.

“Doctors have been talking and listening to their patients for many, many years and particularly in general practice, the doctors get to know their patients extremely well.

“I suppose this conversation is for both the public and not just doctors but other health care professionals, so that perhaps people are coming better prepared to speak to their healthcare professional, doctor or nurse about what their priorities are.”

Dr Calderwood added: “Any patient and person who needs a treatment, who chooses a treatment or decides that a procedure or a medication is the right thing for them, they will still have that treatment.

“This is about doing the right thing for those people.”

Scotland’s Chief Medical Officer Dr Catherine Calderwood.