Thursday, February 7, 2013

Choosing Wisely: More Value, Less Waste

Nine physician specialty societies, along with the American Board of Internal Medicine Foundation and Consumer Reports, identified ways patients and their doctors can cut health care costs while maintaining and even improving quality of care. By listing 45 diagnostic tests or treatments that are overused and have not always shown benefit to patients, the Choosing Wisely campaign encourages patients to ask questions and become more involved in their medical care and encourages doctors to pause before performing tests under certain circumstances.

Health care takes up a significant chunk of the federal budget at 17 percent. That number is expected to jump to 24 percent this year, and expensive tests only add to the bill. The Institute of Medicine estimates that up to 30 percent of U.S. health care spending goes toward unnecessary tests, procedures, hospital stays, and other inefficiencies.

Choosing Wisely, a physician-led campaign, aims to help patients and their doctors weigh the value of various care options. That’s a critical step toward not only addressing escalating costs, but also ensuring that patients are getting high-quality care, says Susan Strate, MD, a Wichita Falls pathologist and vice speaker of the Texas Medical Association House of Delegates.

 “Physicians are uniquely capable of determining what’s best for the patient,” said Dr. Strate. “They are the ones with the most expertise on quality and should be leading that effort. These [Choosing Wisely] lists have been vetted and approved by doctors, and it sets up an opportunity for doctors and patients to really look at some of these treatments and dialogue about them.”

The listed services are not meant to be absolutes, but guidelines, and they include indications when a test or procedure may be appropriate.

In the end, Dr. Strate says, the campaign is not about cookie-cutter medicine but about starting conversations between a patient and his or her doctor on the best method of care. “Every patient is unique” she said. “Quality care is about good clinical judgment, and nothing should supplant that. Period.”

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