As you may recall from Ms. Jones’s experience in modules 1-3, one of her principal complaints regarding the care she received was the unnecessary performance of duplicate tests and the inefficiencies of her medical services. As examined in the first collection, approximately 30% of all health care dollars spent are wasted each year, and the majority of waste is on unnecessary care. The American Board of Internal Medicine (ABIM) Foundation, in recognition of this, has developed materials to help empower both patients and clinicians to make informed decisions in the process of care.
In 2012, the ABIM Foundation launched the “Choosing Wisely” campaign with a call to medical professional societies to identify lists of frequently ordered tests or treatments that “clinicians and patients should question.”1 These lists are meant to spur conversation between doctors and patients so that both parties are aware of what is and is not necessary in the course of care.
Since that time, the Choosing Wisely campaign has moved beyond creating lists; this initiative has contributed to an expansion of professional norms to include addressing the need to improve patient care through thoughtfully curbing overuse. Choosing Wisely has grown to include 75 partners who have published 490 recommendations, and the campaign has spread to at least 18 countries.
Recall from Module 1 Section 3 that one of the simplest ways to improve value for patients is to simultaneously improve care and decrease costs through cutting out unnecessary services. Here are a few examples of unnecessary services:
Blood transfusions that are not warranted.2
Unnecessarily repeated routine lab tests.3
Cancer screening in chronically ill older adults with a limited life expectancy.4
Unnecessary services are the biggest contributor to health care waste, and they often are within the direct control of individual physicians.
Here is the Choosing Wisely list developed by the Society of General Internal Medicine (SGIM), which highlights 5 common areas of potential overuse in primary care:
Society of general Internal Medicine
Released September 12, 2013; revised February 15, 2017
STUDY
Check out this article to explore how medical students are learning to utilize Choosing Wisely at Dell Medical School.
The University of Texas at Austin Dell Medical School
September, 2017