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My Approach

It may seem impossible to provide better care for lower cost, but this assumption is flawed. 

I'm a strong believer that patients should have access to the highest quality care that fits their goals and needs, and is informed by the best available evidence. When it comes to health interventions, more is not always better.

By redesigning policy and pathways according to the evidence, and asking patients about what matters to them, I ensure that patients get the highest quality care in keeping with their goals; at the same time, they are empowered to avoid tests and treatments that provide no benefit, cause harm, and waste resources.

 

Those spared resources can be redirected into things that really matter or into increasing throughput for a limited but important medical process. For example, leading the Nanaimo COVID Assessment Clinic and Testing, I aligned the workflow with the evidence. This eliminated inappropriate tests, cut Covid testing time from 15 to 5 minutes, conserved personal protective equipment (PPE), and in so doing, created a safer process for patients and nurses and increased the number of patients we could see per day.

System redesign, policy development, education, and individual patient care can all benefit from assessment through a high value lens. My professional joy comes from challenging assumptions by asking "why?" and "does that really make sense?" before considering a course of action.

Professional Interests

  • High Value Care

  • Appropriateness & Choosing Wisely

  • Preventing Overdiagnosis

  • Reducing Polypharmacy / De-prescribing

  • Patient-Centred Care

  • Shared Decision-Making

  • Evidence Based Medicine (EBM)

  • Minimally Disruptive Medicine

  • Critical Appraisal

  • Health Technology Assessment (HTA)

  • Medical Education

  • Knowledge Translation

  • Health Systems Design

  • Health Policy
     

Clinical Fields​

  • Family Medicine / Primary Care

  • Hospital Medicine

  • Palliative Care

  • Geriatrics & Frailty

  • Multimorbidity

  • Indigenous Health 

Balance

The best health care starts with understanding patient values and their unique context; with these we can apply the best available evidence and integrate clinician expertise 

Best Available Evidence

Patient Values & Goals

Clinician Expertise

Evidence Based Medicine
(free from conflict of interest)
Shared Decision Making
Outcomes that Matter to Patients
Better Experience for Clinicians
Cost Effectiveness
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