Realistic Medicine: Taking Care - Chief Medical Officer for Scotland Annual Report 2023-2024

The Evolution of Realistic Medicine

Enabling careful and kind care

Focus on understanding what matters to the people we care for and focus on helping them achieve their goals

As care providers we often enter people’s lives at a moment of vulnerability; we must respect this, and hear and seek to understand the voice of those we serve in order to deliver the outcomes that matter to people we care for. Shared decision making sits at the heart of doing the right thing.

Balance biography and biology when applying evidence-informed practice

We must ensure the right balance between the science and the art of care; the best care has biometric and biographical care in equilibrium, balancing evidence, professional judgement, people’s preferences and compassion.

Kindness and compassion sit at the heart of the way we deliver care.

We are all human and vulnerability is exhausting; we all have physical and emotional limits and a tolerance to risk that is dynamic as a consequence. We should reasonably expect the people and system in which we work to acknowledge and respect this, ensuring that we are supported to practise compassionately and manage clinical risk appropriately.

Collaboration is key to providing care that people value and greater job satisfaction

We should give way on professional and personal prerogatives in order to be part of something greater; define what we do as individuals as part of a wider multidisciplinary team and nurture and protect civility, trust and belonging within it. Our teams are greater than the sum of their individual parts, and they will help to support and sustain us.

Use resources wisely to provide sustainable care for our service and our planet.

However well intentioned, some care can be wasteful, risking harm to people and the environment; using a value based approach allows us to balance personal and population-based care better so maintaining, and making best use of, all our resources.

Measure the right things including outcomes that matter to people.

Measurement works best when it is meaningful, proportionate, transparent and used for the purpose of improving quality; when measurement drives transactional care it risks moral injury and harm to staff as well as the people we care for and must be avoided. compassionately and manage clinical risk appropriately.