An Overview of Realistic Medicine

The term Realistic Medicine was first introduced by Scotland’s Chief Medical Officer, Catherine Calderwood, in her annual report from 2016. [1] There were six key themes/principles in this report looking at the challenges that face healthcare practice today and include: build a personalised approach to care;  change our style to shared decision-making; reduce unnecessary variation in practice and outcomes; reduce harm and waste; manage risk better and become improvers and innovators. There is a useful introduction to Realistic Medicine available from NHS GGC. [2]

The second report published in 2017 – Realising Realistic Medicine [3] - set an aim “By 2025, everyone who provides healthcare in Scotland will demonstrate their professionalism through the approaches, behaviours and attitudes of Realistic Medicine.” The report puts Realistic Medicine in an international context, where the social media footprint for #realisticmedicine highlighted significant international interest, and this virtual network helps foster learning and collaboration. Contributions from international figures bring experience and expertise will support Realistic Medicine in Scotland. There is also a “broad international movement with expert consensus and helpful experience around shared aims.” Details of planned engagement with those that access health and care services and the wider public to co-produce a realistic approach to health and social care are outlined. Realistic Medicine is not just related to the work of doctors, but to all of the health and social care workforce in Scotland including multiprofessional/multidisciplinary teams. To create conditions for Realistic Medicine requires a co-ordinated set of actions across all clinical and care professions in Scotland. Case studies are presented at the end of each chapter and further case studies can be found @ www.gov.scot/ISBN/9781786526779.

In 2018, Practising Realistic Medicine [4], the third report followed up on some of the themes from the initial report and intended to support and speed up the transition from principles to practice.

In 2019, Personalising Realistic Medicine [6], several new developments were highlighted including: new Realistic Medicine Clinical Lead posts across NHS Scotland; Value Based Healthcare Improvement Project Fund is inviting bids for local projects; Scottish Atlas of Healthcare Variation launched, in collaboration with Information Services Division (ISD) Scotland[7]; Realistic Medicine Survey of Scottish health and social care professionals attitudes; first ever Citizen’s Jury; and a new Realistic Medicine website was introduced [5].

The Chief Medical Officer’s annual report for 2020-21: Recover, Restore, Renew (published March 2021) gives a chance to reflect on our experience of the COVID-19 pandemic and features good practice and innovation. It also identifies areas that need further development. The pandemic has drawn attention to the need for change and not just with the effects of the pandemic, but with other urgent issues such as the climate crisis. We need to think about how we can contribute to a greener society and reintroduce more sustainable services. We must continue to embrace technology and innovate to build services that meet people's needs, not the needs of our system. The report also addressed the Health of the Nation, Reducing Health Inequalities, and Sustainability of our Workforce. [8]

1. The Scottish Government. Realistic Medicine: Chief Medical Officer for Scotland’s Annual Report 2014-15. Published 2016. https://www2.gov.scot/resource/0049/00492520.pdf
2. https://realisticmedicine.scot/nhs-greater-glasgow-and-clydes-realistic-medicine-training-module/
3. The Scottish Government. Realising Realistic Medicine: Chief Medical Officer for Scotland’s Annual Report 2015-16. Published 2017. https://www.gov.scot/publications/chief-medical-officer-scotland-annual-report-2015-16-realising-realistic-9781786526731/
4. The Scottish Government. Practising Realistic Medicine: Chief Medical Officer for Scotland’s Annual Report 2016-17. Published 2018. https://www.gov.scot/publications/practising-realistic-medicine/
5. https://realisticmedicine.scot/
6. The Scottish Government. Personalising Realistic Medicine: Chief Medical Officer for Scotland’s Annual Report 2017-18. Published 2019. https://www.gov.scot/publications/personalising-realistic-medicine-chief-medical-officer-scotland-annual-report-2017-2018/pages/7/
7. https://www.isdscotland.org/Products-and-Services/Scottish-Atlas-of-Variation/
8. The Scottish Government. The Chief Medical Officer for Scotland’s Annual Report 2020-21: Recover, Restore, Renew. Published 2021. https://www.gov.scot/publications/cmo-annual-report-2020-21/