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The Medical Professionalism Blog

A Key to Success for Choosing Wisely – R.E.S.P.E.C.T

In my post, Fresh Air in the Capital and Throughout the Nation, I wrote about the important ingredients for initial success of the Choosing Wisely® campaign:

  • Right messenger
  • Right message
  • Simple actionable steps
  • Respectful and trusting relationships

In this post, I want to address the last, fourth pillar for the campaign: Respectful and trusting relationships. It is these relationships that will ultimately determine the success of the Choosing Wisely campaign. These respectful relationships are not just patient/provider, but physician/physician, society/member, government/stakeholder and beyond.

  • When clinicians work together in high functioning teams with mutual respect and trust, patients benefit.
  • Quality and costs are dramatically improved when payers, purchasers and the government respect and collaborate with physicians and providers by changing financial incentives to align with redesigned health care delivery systems (e.g., medical homes and accountable care organizations).
  • Patty Gabow, CEO of Denver Health, at her acceptance speech for NCQA’s Quality Award, spoke about the importance of respect in removing waste from the health care system through “lean thinking”. “Waste is disrespectful to [physicians] by asking them to do work with no value and … waste is disrespectful to our patients because it asks them to endure processes with no value and reduces the quality of their care.”
  • When the specialty societies involved in the Choosing Wisely campaign announced the five tests and procedures to question, they did it with much respect for their patients and society members.  The specialty societies reached out to their members in a respectful way to explain why they chose those five tests and procedures. After the lists were published, we have heard of many thoughtful conversations where physicians have discussed the merits of these recommendations.

Through the campaign, we hope to change the tenor and nature of the conversation about waste and unnecessary care that adds no value to patients and is costly to communities and the nation. These conversations can only be productive when all stakeholders come together with respect for the same goal and for each other.

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