Practice Based Small Group Learning – a review of the Realistic Medicine module.

I’m a member of a PBSGL group. We are very small and select, because I work on an island in a small practice, and there aren’t that many GPs in the area. I love our group. We have great rapport, our discussions are free-ranging and we get to eat some great cheese.

Because I am very interested in bringing Realistic Medicine into the way we co-produce health with patients, I thought that this would be a good module to work through.

I was a bit disappointed.

At the heart of Realistic Medicine, there are a number of concepts. One is the balance between evidence-based medicine and the expectations and wishes of patients. Sharing clinical risk is in there, as is the redesign and presentation services in a way that puts patient need first. Reducing unwarranted variation, harm and waste is important.

I was a bit underwhelmed by this module – it could have been a module on multimorbidity and geriatrics, and the level of debate that the cases raised was well within our current scope of practice.

The three cases were all concerning elderly patients, and the tension between evidence based medicine, frailty and multimorbidity. While they were true to life and interesting, at the end of the session we felt we’d learnt more about community services for older patients, rather than about realistic medicine.

The background reading later in the module was of much greater value, and covered many of the concepts of realistic medicine. However, we found it tricky to include this material in the discussion of the cases.

In short, we did not feel that this module stretched our understanding and learning. Maybe that is our failing, rather than that of the module. Was this more about PBSGL jumping on the ‘Realistic Medicine’ bandwagon?