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Fresh Air in the Capital and Throughout the Nation
Last week marked the start of a different type of conversation about the appropriate use and reduction of unnecessary care in the U.S. health care system.
On April 4, nine specialty societies made public their lists of “Five Things Patients and Physicians Should Question.” Many national and local newspapers, broadcast media and blogs covered the story in ways that were refreshing. There were thousands of tweets and comments on blogs, and more than 100,000 visits to www.choosingwisely.org within the first 72 hours of the announcement.
For the most part, there was not a lot of talk about rationing or death panels, which was a pleasant surprise. Rather, there were constructive conversations and applause about the leadership of the specialty societies and the involvement of Consumer Reports. There was some hope that we had turned back a tide of hysteria and polarization around health care reform and could now begin building the health care system we want for ourselves, our children and our grandchildren. It appears that we struck a chord among physicians, patients and other stakeholders without the partisan politics.
Why does this campaign hold such promise?
The messenger was the right one. It was the specialty societies, trusted by their membership to provide the best evidence and advice to its membership, who provided these lists. The empowerment of physicians to act in responsible, professional ways in service of their patients and their communities is aligned with physicians’ most cherished values. Physicians taking leadership with partners such as Consumer Reports is medical professionalism in action.
The message was the right one or at least better than what has preceded it. The discussion was focused on appropriateness, necessary care and reduction of waste – tests and procedures that don’t benefit the patient’s health. It isn’t about cost; it’s about doing no more and no less than that which is in the best interests of the patient. Physician leaders speak of waste as “disrespectful” to all health care employees and patients – providing care without value does not align with the values of the profession.
The actions were straightforward. The societies’ recommendations were fairly straightforward and easy enough to put into practice. Physicians and patients should engage in conversations about the five tests and procedures on the lists.
The campaign was launched with respect to the contributions of the specialty societies and the consumer/patient/employer partners. The specialty societies and Consumer Reports were courageous not knowing what would be the reception. We hope that other stakeholders will begin to constructively contribute to the campaign and don’t extinguish the fire that is beginning to burn bright. This is not about politics, insurance exclusions and payment reductions. This is about building a better health care system with the deep involvement of the profession in partnership with patients.
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