How should I manage medical and surgical diseases in a resource limited setting? How do I decide whether to test or just treat? Should I treat the poor, rural farmer in Africa for mild HTN as I would a farmer in Minnesota? Learn an evidence-based probabilistic approach to rational, ethical, shared decision making with patients in resource limited settings that leads to cost effective care. Learn how to leave expensive, guideline centered, inefficient, futile care and embrace high value, patient-centric, cost effective, sensible care for the poor and medically underserved