The concept of ‘minimally disruptive medicine’ is not mainstream, but should be. MDM is designed to fit the treatment to the patient. In chronic conditions, often the expectation of the doctor, practice and hospital is to do too much. After all, there is the relentless drive to value-based care that improves outcomes and reduces costs that has at its core the absolutely relentless monitoring of delivery metrics and patient compliance (take that med, even if you can’t keep your dinner down). The frustration of the patient with chronic conditions is palpable; it’s not understood, or it’s all too much to handle. We last covered Dr Victor Montori a year ago and in 2013 as proposing that we’re thinking about patients in chronic care management all wrong; that we need to fit the treatment to the patient in order to simplify actions they need to take, to reduce the burden of illness and gain a better outcome. The two-day intensive is at the Mayo Clinic in Rochester, MN, 27-29 September. Registration here. YouTube preview video.
A look again at minimally disruptive healthcare. In June 2013 we wrote about a contrarian approach to treating chronic disease–and now the ‘pre-diseases’ which have been discovered, like Columbus with America, with all good and proactive intentions for the patient. There’s increasing pressure, and rigidity in applying, guidelines and quality standards which are both performance and financially based. Measure, measure, measure!! Prescribe, prescribe, prescribe!! Is your patient at goal? Yet we are losing the Battle of Real Results and improved health. Telehealth and telemedicine are being touted as ways to increase compliance, but do they complicate matters and add to–not reduce–the burden?
We return to the originator of this minimally disruptive approach to care, Victor Montori MD, an endocrinologist at Mayo Clinic, via a MedCityNews article by cardiologist John Mandrola MD and this video from a primary care conference, the NAPCRG annual meeting in New York. (At 45 minutes, you’ll want to save it for later).