Revealing Novel IDEAS: A Fiduciary Framework for Team-Based Prescribing.

Area of Science:

• Medical Education
• Health Services Research
• Pharmacology

Background:

• Current medical curricula emphasize accurate medical indications but neglect other crucial prescribing elements.
• Patient priorities, such as medication desirability, affordability, and safety, are often overlooked in traditional prescribing education.
• The pay-for-value healthcare environment necessitates a shift towards more comprehensive and cost-effective prescribing practices.

Purpose of the Study:

• To introduce and advocate for a patient-centric framework for optimal prescribing.
• To integrate essential prescribing components beyond medical indications into medical education.
• To enhance teamwork and shared decision-making in the prescribing process.

Main Methods:

• Development of the IDEAS (Indicated, Desired, Effective, Affordable, Safe) framework.
• Proposal for integrating this framework into medical curricula and clinical practice.
• Emphasis on delegation and empowerment of the care team for patient education and support.

Main Results:

• The IDEAS framework provides a structured approach to ensure medications are indicated, desired, effective, affordable, and safe.
• Implementation of IDEAS promotes collaboration among healthcare providers and shared decision-making with patients.
• Empowering the care team allows physicians to focus on appropriate indications and real-world effectiveness.

Conclusions:

• The IDEAS framework serves as a valuable mental model for trainees and clinicians, reinforcing sound prescribing habits.
• Adoption of this framework can improve the patient experience, population health, and reduce healthcare costs, aligning with the triple aim.
• Fostering fiduciary responsibility for optimal prescribing is crucial, especially for future physician leaders in a cost-constrained healthcare system.