Synopsis
Current medical practice is appropriately centred around notions of patient-centred care and personalised medicine. These laudable practices are occurring against a background increasing patient empowerment and disruptive patterns of knowledge transfer. Health care consumers are now interconnected and highly aware of biotechnological advances. Both health care providers and consumers want the latest and “best” in therapies, however all too frequently these therapies are both expensive and non-transformative. In a resource-constrained environment these new medical realities are increasingly problematic and potentially unsustainable. How then does one equitably and effectively run a clinical service in a public hospital; balancing the needs of the patient in the consulting room against the needs of the patient in the waiting room in a zero sum game? The diabetes service at RCH has had to consider these issues in an ongoing manner with a rapid increase in treatment complexity occurring against a background of increasing patient numbers and constrained resource allocation. These issues will be analysed through a prism of equity, credibility and control. Potential strategies will be explored looking at determinants of consumer attitudes, clinical decision making and knowledge transfer/implementation science.

Speaker
Professor Fergus Cameron is a paediatric endocrinologist at The Royal Children’s Hospital and has been involved in diabetes care at RCH over a period of many changes in clinical practice. He has struggled to reconcile his Kantian inclinations with an intellectual legacy that has emerged from a long line of reductionists, cynics and doubters. His dilemma is unresolved but hopefully enlightening.