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The Medical Professionalism Blog

Tag Archives: communication

My Lean and Mean Physical Exam

More than two years ago, the Society for General Internal Medicine (SGIM) released its list of Choosing Wisely® recommendations, which included advising against performing routine general health checks for asymptomatic adults. The rationale behind the recommendation was that “regularly scheduled general health checks without a specific cause, including the ‘health maintenance’ annual visit, have not […]

Information Can Empower the Seriously Ill in a Powerless Situation

One of my relatives has metastatic cancer. He has several tumors in his body, one of which measures five centimeters. Two chemotherapy regimens have failed to beat back the disease. Yet, when he’s not in treatment and has no pain, he is able to go about the daily activities of his life, even going to […]

Choosing Wisely®: The Trials and Tribulations of Patients Against Waste

In last week’s New York Times article by Elisabeth Rosenthal, “Patients’ Costs Skyrocket; Specialists’ Income Soar,” we read about the plight of Kim Little, who lives 30 miles from Little Rock, Arkansas. She felt like a hostage when she was told she needed plastic surgery for the removal of non-cancerous mole instead of just a few […]

Atul Gawande’s Lessons for Choosing Wisely®

I read Atul Gawande’s recent article in The New Yorker (07.29.13), “Slow Ideas,” with great interest. In it, Gawande asks, “Why do some innovations spread so swiftly and others so slowly?” I immediately harkened back to the Choosing Wisely campaign.

A Consequence of Choosing Wisely®

In rural Maine, Choosing Wisely brought primary care and specialists together to discuss the recommendations – a positive, unintended consequence of the campaign.

It Was Just a Cough: Wasteful and Potentially Harmful Medicine

Over the past year I’ve written much about the Choosing Wisely® campaign, but a recent personal experience serves as the inspiration for this post.

Choosing Wisely®: Can Stories and Emotions Produce Change?

At the recent annual meeting of the Institute of Healthcare Improvement (IHI), Fred Hafferty of the Mayo Clinic and I gave a presentation on the effect systems have on the professional behaviors of clinicians. I asked the 100 or so attendees if they thought intrinsic (i.e., personal satisfaction and mastery) or extrinsic (i.e., payment) motivators […]

Choosing Wisely®: Kinder Ways of Thinking About Resource Use

The goal of the Choosing Wisely campaign is to encourage conversations between patients and physicians about what tests and procedures are, or are not needed. We hope these conversations provide an opportunity to talk about the benefits and risks of tests and procedures, including potential harms for patients. Choosing Wisely is about thoughtful discussions and […]

Choosing Wisely®: Changing Words is Altering Health Care Policy and Conversations

The Supreme Court’s decision to uphold the Affordable Care Act’s individual mandate as a tax rather than as a permissible use of Congress’ power under the Commerce Clause was a reframing of the legislative issue with real meaning and consequences for the law’s survival.

Choosing Wisely®: It is All About the Conversation

From our communications research, we’ve learned that one of the most difficult challenges physicians say they face in talking to their patients about why a test or procedure is not necessary or will not alter a treatment plan is they simply don’t have enough time during a regular office visit. They often say that if […]