Martin Marshall, a co-founder of the Rethinking Medicine ‘thing’, is Professor of Healthcare Improvement at UCL and Vice Chair of the Royal College of General Practitioners.
Nearly 12 months down the line and I’m still calling Rethinking Medicine a ‘thing’ because I don’t know what else to call it.
‘Initiative’ sounds dry, ‘project’ lacks ambition and ‘programme’ too managerial. The term ‘movement’ sounds grandiose and presumptuous but it comes closest to what we’d like to see.
Movements empower people to question established norms and the exercise of power. The traditional model of medicine has been normalised and is powerful. Surely asking questions that enable the medical model to evolve can only be helpful?
Those of us struggling to frame Rethinking Medicine have reflected on the genesis and evolution of the Evidence Based Medicine Movement in the 1990s. Never has an idea been incorporated into the DNA of the medical profession so rapidly and it didn’t happen by accident. OK, the idea that health professionals should make more systematic use of scientific evidence was hardly revolutionary. But the ways in which the leaders of the movement established a profile for their ideas, engaged in heated debates and built an infrastructure to train EBM activists was impressive and impactful.
Movements empower people to question established norms and the exercise of power.
We recognise that our invitation to rethink medicine presents a bigger and more counter-cultural challenge than that presented by the EBM movement. We are responding to this challenge by developing a narrative that we hope people will find engaging, and a preliminary plan of action .
Some people are critical of what we are trying to do – they say the idea is too big, too focused on doctors, and fails to recognise the amazing achievements delivered by the medical model. But most people have welcomed the ideas enthusiastically – one respondent called our most recent publication “one of the most important BMJ editorials I have ever read”.
And the response of medical students and junior doctors, the future of medicine, has been, “We don’t know why you’re making such a fuss, of course we need to adapt the medical model to make it more relevant to the challenges faced by our patients and communities.”
There’s a long way to go but we think that the rethinking medicine movement – yes, I’ll use that term – is onto something important.