Choosing Wisely Summer Reads

Catch up on some recent Choosing Wisely news. For regular updates, follow #ChoosingWisely on Twitter.

• In “Should Physicians Care about Costs?” The Hospitalist physician editor Danielle Scheurer outlines a May AJMC survey which found that the vast majority of physicians agreed that they need to reduce unnecessary testing and adhere to guidelines and that they have a responsibility to control costs. Almost all physicians who completed the survey agreed that Choosing Wisely was a good source of guidance.  Scheurer points to Choosing Wisely as an effort “to help physicians become aware of and reduce unnecessary utilization of resources” and highlights that Consumer Reports has developed educational materials to engage patients and families.

• Murray Ross, Vice President of Kaiser Foundation Health Plan, identifies four areas in which there have been efforts to differentiate between effective and ineffective health care in his Health Affairs blog post, “What’s In A Word? The Evolution Of Effectiveness In Health Care.” Ross mentions the Choosing Wisely campaign and lists of “Things Providers and Patients Should Question” as a way to build common ground about medical necessity. “The lists are designed in partnership with medical specialty societies to help educate and empower consumers and to enhance health care services,” Ross writes.

• In his recent Forbes article “Out-Of-Control Physicians: Too Many Doctors Are Doing Too Many Things To Too Many Patients,” Peter Ubel, MD, details several studies that show some medical tests and procedures do more harm than good. He cites Choosing Wisely as one campaign to reduce the unnecessary tests and procedures mentioned in recent research. He concludes by noting, “We need to go beyond identifying which clinical practices we need to avoid and go on to develop systems that help us and our patients avoid them.”

• “Scrapping unnecessary labs” in the July edition of Today’s Hospitalist notes how the Society of Hospital Medicine (SHM) focused on curbing inappropriate lab testing as part of the Choosing Wisely campaign. When a benchmarking analysis of general internal medicine hospitalist service at Salt Lake City’s University of Utah Health Care showed higher lab costs per discharge than their top-performing peers, the hospitalists set out to tackle the problem. The hospitalists designed a multifaceted intervention that included educational sessions, standardized rounds and monthly feedback. “During a 14-month intervention period that ended in April 2014, lab costs per day for patients treated by the hospitalist service fell from $138 to $123.”

• USA Today explored emerging technology aimed at helping patients navigate health care decisions and costs in the recent article “New tool searches health prices by doctor, insurance.” Charles Kodner, MD, of the University of Louisville School of Medicine, mentions Choosing Wisely as a way that patients can question their physicians on whether tests are necessary. In the piece, Neel Shah, MD, of Costs of Care notes that physicians can help better explain the possibilities and costs procedures could involve, and Bob Wachter, MD, says that giving patients transparent information is an important way to help them make better informed decisions.

• In an Op-Ed column in The Columbus Dispatch, “Pediatric Research: Program encourages better health care by doing less,” John Barnard, MD, President of the Research Institute at Nationwide Children’s Hospital, shared that he learned that sometimes the best treatment is no treatment during his training to become a pediatrician. Dr. Barnard points out that the Choosing Wisely campaign has enabled patients and clinicians to discuss “care decisions that are supported by research, do not duplicate testing, are as free from harm as possible, and are truly necessary.” He explains how the campaign helped guide a recent conversation with his own doctor.