I recently stumbled on the Minimally Disruptive Medicine blog maintained by Dr. Victor Montori from the Mayo Clinic. I have to admit that the name caught my attention so I scoped it out.
According to Dr. Montori, “minimally disruptive medicine refers to the practice of medicine that seeks to design effective treatment programs for patients while minimizing the burden of treatment.” He describes this as an emerging field.
I have to admit that I was simultaneously puzzled and intrigued.
After all, how is this is different from the way good medicine is practiced? I, for one, like to think that I create individually tailored programs that meet my patient’s needs while minimizing their treatment burden. Communication between providers has always been a challenge but long understood as important. And understanding the capacity of a patient to adhere to treatment should be a basic part of fashioning any treatment plan. I haven’t considered any of these elements as part of an emerging field, however. It’s just good care.
But perhaps we no longer offer good care.
The popularization of minimally disruptive medicine may represent an indicator that medicine is much worse off than I realize. Perhaps the disconnect with patients has become so great that the basic role of the physician has been forgotten and needs to be retrained under this branded rubric.
Perhaps we’ve hit rock-bottom and it’s time to rebuild. Minimally disruptive medicine may be an indicator real trouble. Concierge medicine was our first clue that something was wrong (“Pay me an annual fee so that you don’t get lousy care”). Or, alternatively, minimally disruptive medicine may represent a move to reinvent and re-label the way the best of us like to think we have always cared for patients.
Expect to see more reinvention of the kind of patient care that at one point was the standard. Expect such moves to be positioned as the shiny new thing.
If you can access BMJ, Dr. Montori coauthored a nice summary last year that’s worth a peek. The Mayo Clinic Channel on YouTube has a clip discussing minimally disruptive medicine.
{ 2 comments }
I'm not sure I agree with relabelling a new form of medicine as Dr. Montori has done but I would agree that the practice of medicine is at rock bottom. As a doctor, I've experienced the incredible dissatisfaction patients and colleagues have been feeling for a long time. And, as a patient with a chronic disease, it doesn't take long in the system to realize that few doctors care about practicing good medicine any more – they are just too burned out and too unsure how to move forward in today's broken system.
When our patients hit a rough patch, "we" often advice them to reframe the situation more positively. I feel the medical system is in need of that approach. We know the negatives. What we need now, is to identify the few positives that do exist, embrace them, and build from those. There is still some good, and people doing good, even in this broken climate.
Dr. G
Bryan: I'm not sure if I mentioned this at SXSH, but I'm doing research with Dr. Montori this summer at Mayo! Small world. I'll keep you posted on my thoughts as I get more involved with MDR.
Hope all's well in Houston!