Realistic medicine

Realistic medicine

Realistic Medicine is the Scottish Government’s approach to delivering value-based health and care that aims to put the patient at the centre of decisions made about their care.^18-20 Realistic Medicine is of relevance within all healthcare disciplines, including dentistry, and has six principles: Shared Decision Making, Personalised Approach to Care, Reduce Harm and Waste, Reduce Unwarranted Variation, Manage Risk Better, Become Improvers and Innovators.

Adopting the Realistic Medicine approach aligns with environmental considerations and efforts to achieve more sustainable health care. Climate change represents a major threat to both human health and the health of our planet. The need to minimise the impact we have on the environment is widely acknowledged and National Health Services in the UK are committed to reducing greenhouse gases, the cause of climate change.^21-23

By promoting national categories of care, the Management of Acute Dental Problems guidance contributes to reducing unwarranted variation in the provision of unscheduled care for oral health problems. This will be supported by a linked decision support tool on the Right Decision Service platform which aims to promote wider engagement with the target audience of the guidance, including non-dental healthcare professionals.

The Management of Acute Dental Problems guidance provides advice on clinical situations where antibiotics are indicated and oral conditions for which antibiotics should not be prescribed. By promoting the avoidance of unnecessary antibiotic prescribing, the guidance supports the Realistic Medicine principle of reducing harm and waste.

Shared decision making is a key principle of Realistic Medicine and aligns with the three elements of evidence-based practice: patient values and preferences, clinical expertise and best available evidence. It is recognised that, in certain circumstances, clinical judgment may support deviation from this guidance where this better serves the individual needs and values of the patient. Such decisions must be made transparently and documented appropriately.

Further information about Realistic Medicine and educational resources are available via the Right Decision Service Realistic Medicine - National toolkit for professionals.