The new Scottish chief medical officer has called for a drive against over-treatment in her first annual report.
Dr Catherine Calderwood made “realistic medicine” the theme of her report, calling for doctors to spend more time discussing treatment choices with patients.
These may include deciding not to have treatment, she says.
Doctors should question variations in practice and outcomes and aim to reduce waste, she says.
Scotland’s new chief medical officer is an obstetrician and gynaecologist.
In her report she warns that public pressure and increases in available medicines – together with growing number of people with multiple conditions – can sometimes lead to over-treatment.
She said: “In striving to provide relief from discomfort, illness and death, modern medicine can sometimes over-reach itself and provide treatment that is of little long-term benefit to the patient. This is especially true when a person has multiple conditions, each of which has its own list of recommended medicines and treatments.
“Realistic medicine is about moving away from the ‘doctor knows best’ culture. It’s about more fully involving patients in the decisions about their care. Of course this will only happen if people are prepared to have these conversations in this way with their doctors.”
The report was welcomed by Professor Derek Bell, president of the Royal College of Physicians of Edinburgh. He noted that the report cited medical trainees as crucial to the future of the NHS.
He said: “We particularly endorse the proposals to avoid overtreatment and excessive prescribing, while increasing attempts to support individual and population lifestyle changes.”
But British Medical Association Scottish chair Dr Peter Bennie said: “It is good to see Dr Calderwood acknowledge the critical role doctors must play in shaping how medicine is practised in the future and how healthcare is delivered, to secure high quality patient care and the overall health of our nation.
“But whilst doctors can play a vital part in supporting the development of new approaches to healthcare models we must recognise that morale amongst Scotland’s doctors is very low with workload intensity continuing to rise, and that this is likely to have an effect on how well doctors can respond to the needs of a changing health care service and growing patient demand.”
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