End of Guidelines (Video parody by James McCormack feat. ZDoggMD + friends)

James McCormack (@medmyths, BS Medicine Podcast) does it again!

Clinical Practice Guidelines must change! This is the end of guidelines as we know them.

Yes that is me and Gilbert Welch on the same screen. For realz!

Yes that is me and Gilbert Welch on the same screen. For realz!

We need patient centred care, including discussion of the values of the patient, the harms of intervention, and alternative options. Right now we have a bunch of arbitrary target numbers for treatment that medicalize normal people. These guidelines are mired in conflict of interest as the majority of guideline-authors having egregious conflicts of interest with industry. 

It's time to fix this! I'm honoured to be a part of this effort and call for action. It was awesome fuel for my imposter syndrome being asked to be in one of James' videos alongside some of my 'preventing overdiagnosis' heroes, not to mention ZDoggMD (whose videos I have followed for ages, probably since Hard Doc Life). The video features such like-minded pals including but not limited to: Gilbert Welch, Tim Caulfield, Iona Heath, Victor Montori, Richard Lehman and yep, yours truly - "it's just common sense!"

See for yourself and share widely:

Source: https://www.youtube.com/watch?v=DHDnqQ_mCB...

Ten Commandments for patient-centred treatment | British Journal of General Practice

One of James' slides from a talk we did with an older version of the commandments

One of James' slides from a talk we did with an older version of the commandments

I first encountered the 10 New Therapeutic Commandments when I started working with James McCormack on a lecture for medical students at the University of British Columbia.

Evolving from the chapter ‘The new therapeutics. Ten commandments’ by John S Yudkin in The Good GP Training Guide, they've developed into something completely wonderful.

I expect these capture the practice philosophy of most people who are interested in "Less is More" and "Choosing Wisely," and looking at them now, I think perhaps we should have devoted the entire lecture to this one slide.

See for yourself, the list and explanations, in the British Journal of General Practice.


My top 3 from the 10

1. Thou shalt have no aim except to help patients, according to the goals they wish to achieve

I think this could be the modern version of the most eminent aspect of the Hippocratic oath; not doing harm becomes respecting patient goals above all else)

2. Thou shalt always seek knowledge of the benefits, harms, and costs of treatment, and share this knowledge at all times

It is impossible to have an informed discussion and consent if one isn't informed.

7. Honour thy older patients, for although they often have the highest risk, they may also have the highest risk of harm from treatment


. . . 

Look at the list to see the rest!


Source: http://bjgp.org/content/65/639/532

MedStopper de-prescribing online app now live!

It is with great pleasure that I introduce: 


Polypharmacy, the state of being on multiple (too many) medications, is an increasingly recognized problem. Though variably defined, everyone agrees that polypharmacy leads to dangerous consequences for patients, particularly in the elderly.

It is so much easier to start than to stop a medication. Now, there is help!

An incredible team, mostly from British Columbia, many of whom I'm had the pleasure of working with, have developed this superb resource. MedStopper is an online tool to help stop medications for patients.

Aimed at clinicians, this deprescribing aid allows you to created a medication list, suggests which medications need to be stopped first, and advises the safest way to go about stopping them. 

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Smiley/frowny faces show you the extent to which the medicine: may improve symptoms, may reduce risk for future illness, and may cause harm. If the patient is considered frail, the recommendations are adjusted accordingly.

The tool is a synthesis of many things, so you can view the Beers/STOPP criteria, the NNT or a risk/benefit calculator if available, and print out the plan if you desire.

Not sure if you (or your patients) are on too many medications? Use the Rxisk questionnaire.

Try out MedStopper today and be sure to use the feedback section to let the team know if there are any glitches or errors.

Congratulations to the group on creating this hands-on, easy to use, and practice changing tool. 

Source: http://medstopper.com/

VIDEO: Bridge Over Diagnosis - a parody of Bridge Over Troubled Water

Another great video from the talented and goofy Dr. James McCormack (@medmyths) of Best Science Medicine Podcast fame.

Bridge Over Diagnosis - a parody of the Simon and Garfunkel classic Bridge Over Troubled Water. Overdiagnosis is an important health care issue and hopefully this video highlights a number of the issues around this important problem.

If you like this, don't forget to see James' (in my mind) even more catchy and fun Choosing Wisely video parody of Pharell Williams' "Happy"

Source: https://www.youtube.com/watch?v=gfesuNG0-k...

Choosing Wisely - a catchy music video by James McCormack

"It might seem crazy . . . Less is More can often be the Best Way."

Dr James McCormack, co-host of the Best Science (BS) Medicine Podcast at Therapeutics Education Collaboration, created this video. It's a parody of the Pharrell Williams song "Happy," adapted to promote the concepts of evidence-based medicine, shared decision making and common sense to healthcare providers and patients.

The catchy tune highlights some suggestions from the Choosing Wisely campaign (US) and the Choosing Wisely Canada recommendations as well as ideas for using your common sense to be healthy!

Check out the video, show it to your doctor or patients, and start a healthy Less IS More conversation.

James and I will be doing a talk to the UBC Medical students this fall; I only hope we can be half as engaging. Great work, James!