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Joining the Choosing Wisely Campaign
The Choosing Wisely® campaign’s focus is on developing conversations between patients and physicians and among physicians about appropriate care and smart decisions. The catalyst for these conversations and decisions are the “Five Things” lists of tests and procedures where there is little or no evidence on their effectiveness in diagnosing or treating an illness. Through this campaign, we hope physicians will begin to think about evidence, and ask themselves how a certain test or procedure will help them make a diagnosis and/or how it would alter a treatment plan. Physicians I’ve spoken to also tell me the campaign is about acknowledging and managing the fact that no physician can ultimately be 100% certain about knowing what is going to make a difference to the patient’s health.
Choosing Wisely is a campaign that we hope inspires others to join in the conversation about these, and other tests and procedures that may be unnecessary. We hope to hear from members from the following groups:
Practicing Physicians: The next time one of the tests or procedures from one of the“Five Things” lists is requested from a patient or caregiver, talk with your patient about the specialty society’s recommendations. If you practice in a group, speak with the other physicians about these recommendations and how you want to handle them in your practice. How important to your practice is it to eliminate care you are currently providing? Is this care part of the economics of your practice? Are there other tests or procedures that should be talked about?
Patients: When a physician recommends a test and procedure on these lists, or that you think you might not need, talk to your doctor about the benefits to you and your health. Will it help make a diagnosis? Will it ultimately restore your health or relieve pain?
Medical Leaders from Health Systems and Hospitals: Examine the lists and begin discussions about whether some of the tests normally conducted should be revisited. What are the exceptions to these recommendations and how should they be handled? How are you going to involve your admitting physicians, hospitalists and patients in these discussions? How can you recognize appropriate use of resources? How would your business model need to change?
Medical schools and residency programs: Choosing Wisely is potentially a learning opportunity for medical students and residents. Learning how to read evidence-based studies and think about probabilistic theory is a competency needed by learners and faculty. Might medical schools and residency programs develop their own lists of five tests and procedures as a way of thinking about decision-making and utilization of services?
All stakeholders in our health care system have a role to play in Choosing Wisely. Please share your thoughts, ideas, and stories of success so we can learn from one another and make better decisions about our health care.
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