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The Medical Professionalism Blog

The Importance of Choosing Wisely

On April 4th as part of the Choosing Wisely™ campaign, nine medical specialties will announce their lists of five tests and procedures patients and physicians should question due to lack of evidence about their benefits.

The nine specialty societies include:

  • American Academy of Allergy Asthma & Immunology
  • American Academy of Family Physicians
  • American College of Cardiology
  • American College of Physicians
  • American College of Radiology
  • American Gastroenterological Association
  • American Society of Clinical Oncology
  • American Society of Nephrology
  • American Society of Nuclear Cardiology

On that same date, we will also welcome eight additional specialty societies to the campaign whose lists will be developed and announced in the fall.

Why is this campaign so important?

Leadership: This campaign is professionalism in action. Specialty societies are providing leadership and demonstrating courage in advancing conversations about appropriate care, and tests and procedures that don’t benefit patients and in some instances harm them. The Physician Charter states:

“While meeting the needs of individual patients, physicians are required to provide health care that is based on the wise and cost-effective management of limited clinical resources…The physician’s professional responsibility for appropriate allocation of resources requires scrupulous avoidance of superfluous tests and procedures.”

In response to this commitment, the profession has assembled a list of actionable recommendations and invited a conversation with patients and the public on overuse. Each of their recommendations require physicians and patients to make wise decisions together about tests and procedures where there is no evidence or evidence only for a specific population of patients.

Health, Quality and Safety:  The aim of Choosing Wisely is to stimulate physician and patient conversations as a way to increase awareness of the issue of appropriate care and to improve the quality and safety of health care. Better quality and safety improves the health of the population and reduces the cost of care for tests and procedures that are wasteful and without value. Current cost trends make the health care system economically unsustainable. But eliminating beneficial care to reduce overall costs is not the aim of this effort. There is far more money to be saved if quality and safety are improved than reducing prices.

Conversations:  This campaign asks physicians and patients to have open and knowledgeable conversations about any recommended test and procedures. Better decision-making with engaged patients yields the best outcome for each individual patient. We need to change the conversation from fear about withholding needed care to talking about the right care, at the right place and right amount of it. We are confident that our partner Consumer Reports can lead the charge to provide easy-to-read and understand information for patients based on the specialty society recommendations.

Choosing Wisely is an important first step in improving care for all Americans. We look forward to the next.

1 Comment to The Importance of Choosing Wisely

  • March 29, 2012 at 4:21 pm | Permalink

    Shall we consider the following—How often HgBA1C testing in type 2 Diabetes—-how often urine cultures for Sx of UTI—-how often renal function testing in stage 4 CKD—-how often pacemaker checks—-how often cardiac stress testing—-How often troponin testing for chest pain

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