Evidence 2010 and minimally disruptive medicine

By Victor Montori

On November 1 and 2nd, clinicians, policymakers, and methodologists got together at the BMA House in London, UK for the Evidence 2010 meeting.  The BMJ and Oxford’s Center for Evidence-based Medicine convened the meeting and it was a major success.

I had the opportunity to participate as a keynote speaker opening day 2.  While I can summarize my presentation (the content and slides are elsewhere on this site), the colorful summary published in the BMJ does a much better job.  You can read it here.  The key paragraphs follow:

His strategy combines better explanations to patients of the benefits they may be missing, and giving them a chance to “choose their own poison” by taking them through the treatment options in a gentle conversation. A patient who has been given a choice is more likely to adhere to the treatment, whatever is chosen, he believes.

He also believes in “minimally disruptive medicine,” trying to devise a strategy that does not leave the patient spending hours each day organising his pills, arranging tests and appointments, and worrying about his disease. For a diabetic patient with multiple co-morbidities, doing this can turn into “a part time job” Dr Montori said.

Language needs to be changed, too. “LDL cholesterol is not a word” he asserted. “I have to talk to my patients about living longer, feeling better, and living unhindered by the complications of the disease. If I can’t do that, I shouldn’t be treating them.”

I am grateful to my colleagues at CEBM and BMJ for the invitation and I look forward to Evidence 2011.  I will post an update here when the organizers post the video of the presentation online.



One thought on “Evidence 2010 and minimally disruptive medicine

  1. “Language needs to be changed, too.”
    One must use terminology that enables patients to make informed, rational decisions. While at a meeting last summer with a gastro practice, we were discussing low colorectal screening adherence rates. I told them how to attempt to solve it – start focusing on communicating to the patients the colon cancer prevention aspect and not the procedure aspect of screening – the uncomfortable colonoscopy. If people understand the probability of getting CRC decreases ~60-90% with colonoscopy and polypectomy, they will focus on that instead of the miserable prep. At least that is what I hope they would do.

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