Creating value in musculoskeletal care with Dr Imran Sajid. Episode #419

Dr Imran Sajid is a frontline clinician, health policy maker, educator and researcher with a keen interest in behavioural economics. This podcast takes a 30,000-foot view of some of our daily clinical approaches—and dives down into specific cases to make important points. How do you get the right care to the right patient at the right time. Is there overdiagnosis and overtreatment in our field—the field of musculoskeletal care? Fee-for-service underpins a great deal of treatment in MSK medicine. Are our diagnoses (such as ‘locked knee’) really as solid as we may have been taught in the early 2000s? Do very common surgical procedures such as knee and shoulder arthroscopy add value for the patient? Dr Sajid gives 3 tips to improve the value of care for patients: 1) We need system change so the right care is provided at the right place. This generally requires a shift towards shared care in the community setting. 2) There needs to be a culture change away from the structural model—most health care burden does not derive from structures that can be fixed simply with a pill or a screw. 3) Clinicians need to be healthy skeptics about what works and what doesn’t. Humility helps! Don’t fall prey to those powerful cognitive biases. Just

because we know about them doesn’t make them go away. Think of your favourite optical illusion! It’s hard to ‘see’ the truth!