Daniel Wolfson, MHSA, executive vice president and chief operating officer of the American Board of Internal Medicine Foundation, hears a lot of stories about over-use and unnecessary care in his travels as head of the ABIM Foundation’s Choosing Wisely campaign. He even has his own example of receiving four EKGs prior to cataract surgery, even though he had no cardiac risk factors. When he questioned the need for the EKG, the anesthesiologist revealed that he didn’t want to run the risk of being sued for missing an unlikely chance of atrial fibrillation – a heart rhythm disorder.
“We can’t work that way anymore,” said Wolfson. According to a study published in JAMA in 2012, overtreatment, or care that is duplicative or unnecessary, accounts for 30 percent of health care delivered in the U.S. Eliminating overtreatment could save $270 billion in health care spending annually.
That’s where the Choosing Wisely campaign comes in. The campaign began in 2012 as a way to raise awareness among physicians and patients of the harm and expense that occurs when patients receive more treatment than necessary. Choosing Wisely aims to increase conversations among patients and physicians about overuse, and to help patients make smart, effective choices for their care.
Physicians and health professionals from nearly 70 medical and related societies have created lists of the top five things patients and physicians should question. Consumer Reports helps get the word out to patients. The campaign is physician-led and evidence-based. And it’s working. In just two years, market research indicates that 20% of physicians nationally are aware of the Choosing Wisely campaign and its purpose.
Physicians who participate in the Health Care Resource Stewardship Council, a voluntary subgroup of the Physician Group Incentive Program (PGIP), were among those who talked with Wolfson during a special presentation October 23. Wolfson stressed to the Council that the success of Choosing Wisely lies with the physicians and health providers who put the concepts into practice.
“Physicians and health networks are putting this campaign into action locally,” says Wolfson. “It’s up to you to make this work.”
The Health Care Resource Stewardship Council is looking at ways the physician organizations that participate in PGIP can support and implement the Choosing Wisely recommendations in their practices.