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It’s incredible to see Choosing Wisely spread throughout delivery systems, local communities and internationally. To see it grow in residency programs gives me particular joy knowing that the next generation of physicians will have competencies in stewardship and systems-based practice that surpass the current physician workforce.
Last week, 21 sub-grantees of the Robert Wood Johnson Foundation assembled at the Choosing Wisely Summit to learn from each other, advance skills to spread the awareness of the campaign and plan for the future. The event was a great success; I felt that all of the grantees were re-energized after sharing their stories and learning about the work of their peers. One of the simplest yet most profound takeaways from the meeting—for me, at least—was the reminder of the old adage, “if at first you don’t succeed, try again.”
On April 30, 21 diverse organizations will convene to present their findings and learn from each other about ways to advance the Choosing Wisely campaign at the local level. The ten regional health collaboratives and eleven specialty societies and state medical associations are sub-grantees of the Robert Wood Johnson Foundation (RWJF) and dedicated to improving the quality, patient experience and affordability of health care. They also share the commitment to use the framing of the Choosing Wisely campaign around waste and doing no harm to advance conversations between patients and physicians. They are connectors of organizations, patients, physicians and conversations around the Choosing Wisely campaign. They link the voice of the patient with the voice of the physician, setting this campaign apart from previous efforts: patient-physician partnership and physician leadership.
This type of analysis is a critical part of the transparent, honest dialogue about the issues of unnecessary medical care that we have sought to encourage since launching the campaign. That said, we think it is unfortunately shortsighted to measure the success of Choosing Wisely based on whether or not the physicians involved have cut their own income. Read more »
There is an interesting conversation taking place around Choosing Wisely® and a recent JAMA study by Pearson and Gliwa. It’s heartening to see that the campaign is doing what it was always meant to do – spark conversation.
In their study, Gliwa and Pearson sought to “evaluate the role that evidence on benefits, risks, and costs plays in selecting a service for the Top 5 lists.” They conclude “Specialty societies can enhance trust in the Choosing Wisely campaign by defining more clearly the types of potentially wasteful medical care they seek to eliminate, and by providing a clear evidentiary justification for the selection of each service.”
Tackling the concept of “waste” in health care is not an easy thing. There are many factors that contribute to waste – higher costs and unnecessary treatments being only a couple of them. In the end, the Choosing Wisely campaign originated out of the desire to provide a space for waste to be discussed—between physicians and their patients, groups of physicians and physicians and the organizations in which they work.
On March 27, HealthInsight Utah hosted a town hall on the campus of the University of Utah. HealthInsight Utah is a sub-grantee of a Robert Wood Johnson Foundation grant to the ABIM Foundation to increase awareness of the Choosing Wisely campaign at the local level. They are one of 21 grantees who are all pursuing tactics to initiate conversations about overuse.
The essence of the Choosing Wisely campaign has been captured in four short yet inspiring videos that are now available on the Choosing Wisely website. The videos provide another vehicle to express the tenets of the Choosing Wisely campaign. In them, 18 leaders in health care—all with diverse roles—articulate ways in which the campaign remains rooted in physician professionalism and leadership, and the partnership between the patient and physician in deciding what care is most appropriate.
Steve Weinberger, MD, Executive Vice President of the American College of Physicians (ACP), has called for stewardship of resources to be considered a seventh competency of Accreditation Council for Graduate Medical Education (ACGME) and the American Board of Medical Specialties (ABMS) because of its importance to quality, safety and affordability. While the widespread participation in Choosing Wisely by specialty societies has called attention to the need for physicians to possess the necessary knowledge, skills and attitudes to be good stewards of health care resources, the question we heard from many educators after they are convinced stewardship is an essential competency is how do residents and students learn about these competencies – how do I teach it?
Overuse of antibiotics represents a serious challenge facing the health care system. This week, a number of well-known organizations, inspired by the aims of the Choosing Wisely® campaign, came together to focus their efforts on this issue.
I couldn’t be more pleased that the Choosing Wisely campaign is finding its way across international borders. Choosing Wisely Canada will be operational this fall under the umbrella of the Canadian Medical Association and guided by the University of Toronto. At least eight Canadian specialty societies will release lists of five tests and procedures to question and others are expected to follow. The Netherlands, Germany, United Kingdom, Denmark, Italy, New Zealand, Australia and Israel have all expressed interest in implementing the campaign. While the ABIM Foundation has not deliberately tried to advance Choosing Wisely to other countries, we are nonetheless supportive of these efforts and have provided guidance as they move forward with their own initiatives.