Value Institute Fall Symposium 2016 – Dr. H. Gilbert Welch

Gilbert Welch, M.D., MPH, professor of Medicine and Community & Family Medicine in The Geisel School of Medicine at Dartmouth University, was the keynote speaker at the Value Institute Fall Symposium. Welch’s research has often focused on the problems created by medicine’s efforts to detect early disease.

While medicine offers tremendous benefits to patients who are acutely ill, when clinical issues are not life-threatening there is often a good reason for providers to be wary, lest they test too often and treat too aggressively.

Finding ways to strike a “Goldilocks balance” — treating not too little or too much — was the theme of a lively keynote address at the Value Institute Fall Symposium, Nov. 15 at the John H. Ammon Medical Education Center.

A Christiana Care panel engaged with Dr. Welch in a wide-ranging discussion moderated by Eric V. Jackson, M.D., MBA, associate director of the Value Institute and director of the Center for Health Care Delivery Science. Insights from the panel included:

  • Omar Khan, M.D., MHS, FAAFP, physician leader for the Primary Care & Community Medicine Service Line and medical director for Community Health and the Eugene duPont Preventive Medicine & Rehabilitation Institute addressed the importance of family doctors. He pointed out that primary care physicians have the opportunity and privilege of becoming an integral part of their patients’ lives, encouraging their efforts to improve their diet and exercise, and helping them negotiate the puzzling and sometimes conflicting advice that can lead to unnecessary interventions.
  • Teresa Corbo, Pharm.D., MHCDS, FASHP, vice president of Christiana Care Pharmacy Services, and Value-Institute-Dartmouth Scholar, was asked how the less-is-more approach applies to prescriptions. She said that the most common side effects of medications are often presented to patients, but this does not always include all of a drug’s potential secondary effects. Patients can’t make a fully informed decision unless the drug’s full profile is shared.
  • Daniel J. Elliott, M.D., MSCE, FACP, medical director of Quality Partners and the Quality Partners Accountable Care Organization and a Research Scholar in the Value Institutem, discussed areas of improvement in communication with patients. He noted the challenge of explaining relative and absolute risk when describing medical options to patients. Both are important, but unless options are boiled down to something easy to explain, it is hard to incorporate these concepts into everyday practice.
  • Bettina Tweardy Riveros, Esq., chief health equity officer, spoke about ways to empower Delawareans to take more control of their health through positive food choices. She observed that The Food Trust, a non-profit that helps make affordable nutritious food accessible to everyone, is working in Delaware communities to encourage the development of healthy food retail, expand the variety of food offerings and provide consumers with information to support healthy decisions.