Minimally Disruptive Medicine

One of the features of my work, first of all around chronic disease management in primary care, and then around telemedicine and related technologies, is the sense that patients are increasingly burdened by the delivery, management and organization of their own treatments. This is especially true as the 'self-care' revolution takes off. With Victor Montori and Fances Mair, I have proposed that we need Minimally Disruptive Medicine. The aim here is to accept that the burden of work transferred from the clinic to the home is growing steadily greater, and that the burden of illness plus the burden of treatment may be too great for some people to bear. This is especially the case as a growing population of older people suffer an increasing number of co-morbidities. This view stems from the ways that we are using Normalization Process Theory to think about the new kinds of healthcare work that are implemented, embedded, and integrated, in everyday life - and which are crossing the boundaries between the clinic and the home.