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Choosing Wisely® and the Rubik’s Cube®
After speaking at an academic medical center and physician-run health plan about Choosing Wisely, a physician told me that he had concluded that the complexity of implementing the Choosing Wisely recommendations was like solving a Rubik’s Cube. I took that to mean there were multiple changes that all had to align before the recommendations could [...]
Postscript on Incurable and Irreversible: A Story of Overuse and Underuse at the End-of-Life
In my previous post, Incurable and Irreversible, I addressed the ambiguous language of my mother-in-law’s advanced directive at the time of her initial stroke. This post addresses the events surrounding my mother-in-law’s final days. During her stay in the hospital after her stroke, we were confronted by the decision whether or not my mother-in-law should [...]
Choosing Wisely®: Let the Sunshine In
The day we launched the Choosing Wisely campaign, one year ago, we never envisioned that it would attract the attention of so many physicians across the county. Choosing Wisely has become a catalyst for conversations between patients and physicians. It has provided tools to support both patients and physicians in the pursuit of appropriate health [...]
Grants Take Choosing Wisely® from Grasstops to Grassroots
The Choosing Wisely® campaign has attracted a lot of attention from the so-called “grasstops” in the form of physician leaders, policy makers, researchers, delivery system leaders, journal authors and the media. This top-down strategy was necessary given a political environment that invoked terms such as “rationing” and “death panels.” Yet, the “grasstops” strategy of the [...]
Choosing Wisely®: Thank Goodness Patients Aren’t What They Use to Be!
This post first appeared on Informed Medical Decisions Foundation‘s blog. The patient-physician relationship of yore was pretty much one-sided. Physicians used to tell their patients what tests and procedures needed to be done and didn’t really offer much information on their condition, nor were patients asked to be involved in decisions regarding their own care. [...]
Selling Proton Therapy to the Public: High Costs Without Benefit
Arriving in a train station in a Northeast city the other day, I was struck by the number of advertisements for proton therapy at a local academic medical center (AMC) plastered throughout the station and in local subways. The ads feature a bicycle racer with the tag line: “THE WIND IN YOUR FACE IS WORTH [...]
Incurable and Irreversible
My Argentinean mother-in-law is 95 years old and suffers from advancing dementia. She has lived with my sister-in-law for the last eight years and both of her daughters are considered her caregivers. A person comes to the house for about seven hours a day to assist her in activities of daily living. After suffering what [...]
Choosing Wisely®: We Have Just Begun
“The campaign has turned into a movement,” said Christine K. Cassel, CEO of the ABIM Foundation and American Board of Internal Medicine at the February 21st Choosing Wisely® announcement of 18 additional lists of tests physicians and patients should question. Since April 4, 2012, we have received tremendous gifts from the partners in the Choosing [...]
Choosing Wisely®: Continuing Conversations Between Physicians and Patients About Resource Use
In April 2012, the ABIM Foundation, Consumer Reports and nine courageous medical specialty societies launched the Choosing Wisely®campaign by announcing lists of tests and procedures that were prone to overuse and should be discussed between physicians and patients. Today, I’m proud to share that 17 societies are releasing new lists, totaling 90 new things that [...]
Where Do the Savings Go When Waste is Removed?
Recently, I spoke on a panel at a NEHI (New England Health Institute) Roundtable Discussion in Washington, DC on bending the cost curve. NEHI had released a list of actions that could reduce costs by more than $700 million and improve quality of care. Their recommendations included reducing medication errors, reducing antibiotic use, improving patient [...]
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