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July 22nd, 2015

Reflections after the 2015 Sydney ISDM-ISEHC Conference: The Triumph of the Patient

By Victor M. Montori

I was not able to stay until the last day of the event so my reflections are limited to what I saw directly and through discussions in persons and twitter posts (using the hashtag #ISDMISEHC). I will not belabor the obvious: this was a resounding success for the organizing committee – Lyndal Trevena, Kirsten McCaffery and Paul Glasziou deserve our recognition and gratitude. Their colleagues – always diligent, helpful, and friendly – kept everything going smoothly. It is not an exaggeration that the crowd not only learned, but talked, laughed, hugged, argued, and enjoyed like only a functional family would.

 

That two organizations got together in Sydney was not evident. The program did not force a distinction, but I have to say that I saw much less of ISEHC than of ISDM if I had to draw one. The choice was to show what Thomas Agoritsas portrayed as a yin-yang of EBM and SDM. When EBM was center-stage it was emphasizing knowledge translation and training in the capable hands of Sharon Straus and France Legare respectively. And the synthesis either took a technological spin in the hands of the Magic app (the Norwegian-Swiss-North American collaboration featuring the brilliant Anja Fog Heen's promising work on the inclusion of practical considerations in SDM tools) or a patient-centered one in the multiple presentations featuring coaching and education to facilitate patient involvement in decision making or a series of efforts directed at the clinical encounter.

 

I was proud of the KER UNIT showing at the meeting: ethics, health policy, health care research, and innovation were all areas in which our colleagues took central roles. I would like to highlight our oral presentations, poster presentations, workshop on SDM implementation, and our inaugural keynote. This was Ian Hargraves first ISDM meeting and it became clear how lucky we are to have someone who understands the practices necessary to achieve patient-centered care as well as a series of philosophical underpinnings necessary for this very human task. It was also a grand slam for Kasey Boehmer whose clever, elegant, and profoundly human presentations focused on capacity assessment and elicitation using the ICAN tool captured the imagination of participants. Juan Pablo Brito did triple function: on the EBM side as the audience engaged in problem-solving the issue of overdiagnosis nicely framed by the local Alex Barratt; on the SDM side he presented his work with an encounter decision aid for Graves Disease; and on the international side, he connected with colleagues from Argentina, Chile, Peru, and Colombia to jumpstart a Latin-American SDM initiative that resists getting going.  Annie LeBlanc joined them to complete our participation with a workshop on how to implement SDM in practice.

 

It was particularly tough for me to leave early. Emotionally, because this is THE meeting in which I get to see and enjoy family and friends doing what they love to do.  Also, because I did not get to spend enough time with people I would have loved to spend more time. And because I did connect more deeply with some with whom I had one of those conversations you wish never end. Intellectually, it was hard for me to prepare the keynote address. It was a new talk and I respect this group too much to not try to offer them my best. Ian, Kasey, Annie, and Jon Tilburt (once a KER UNIT pig, always a KER UNIT pig) can testify of my angst. As I finished and reached for a glass of water, my hands were shaking, my mouth dry, and my heart racing. I was feeling exhausted and unusually emotional. During the Q&A, I recognized a possible explanation: my message had connected with what brought us all to Sydney. We were all there because of our commitment to patients.  For a minute, the discussion was not primarily about money, value, cost containment, and austerity. As one of the presenters asked for a simple message to take home; the choice was clear, but not simple: we need a health care that is careful and kind.

 

We are turning the ISDM 2013 website off. The 2015 ISDM website will live on as a testimony of this year’s successful joint meeting, until the next time the SDM community (with ISEHC? I do not know, but I wish for this synthesis to continue) gets together in 2017. In the meantime, I come home recharged and hopeful: brilliant people are trying to change the world for the right reasons for those who suffer. May the force be with them. Until the next time.

Tags: Evidence based medicine, Minimally disruptive medicine, Patient engagement, Research in SDM, SDM in practice, Shared decision making

Comment


France Legare
@francelegare

Posts: 1
Joined: Jul 22, 2015
Posted by @francelegare, Jul 22, 2015

Thanks Victor and take good care,

France


Victor M. Montori
@manosin

Posts: 28
Joined: Feb 07, 2011
Posted by @manosin, Jul 22, 2015

Gone. Back on 7/27.15.

If your message (not about patient care) is urgent perhaps Kirsten can help (Fleming.Kirsten@mayo.edu / (507) 293 0175).

For patient care issues, please contact Toni Ohm at ohm.toni@mayo.edu or at (507) 266 3769

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