In the field of medicine, the customer is not always right, but that doesn't necessarily stop physicians from ordering tests and procedures that may not be strictly medically indicated.
Recognizing this problem, the AAFP has joined with 10 other organizations in the Choosing Wisely(www.ChoosingWisely.org) campaign, which is designed to develop a series of evidence-based lists of medical tests, procedures and other services that patients and physicians should question. Originally piloted by the National Physicians Alliance, the goal of the lists is to help physicians and patients think and talk about overuse or misuse of health care resources.
"For decades, family physicians have worked to ensure high-quality, cost-effective care for our patients," said AAFP President Glen Stream, M.D., M.B.I., of Spokane, Wash., in a joint news release. "Maintaining ongoing relationships with our patients throughout their lifespan helps us provide the best care possible and significantly decreases the need to order tests and procedures.
"The comprehensive, integrated care provided through a patient-centered medical home significantly reduces duplication and eliminates unnecessary treatment. It also encourages an open dialogue between physicians and patients, which helps them 'choose wisely' when it comes to a treatment plan."
In addition to the Academy, the following organizations are participating in the campaign:
American Board of Internal Medicine Foundation;
American Academy of Asthma, Allergy and Immunology;
American College of Cardiology;
American College of Physicians;
American College of Radiology;
American Society of Clinical Oncology;
American Gastroenterological Association;
American Society of Nephrology;
American Society of Nuclear Cardiology; and
The lists the medical specialty organizations have agreed to develop will be available in April and will be based on the following parameters:
- each item should be within the specialty's purview and control,
- procedures should be used frequently and carry a significant cost, and
- evidence must be presented to support each recommendation.
The Consumer Reports Health Ratings Center will take the lead on consumer communications about the campaign.
According to campaign materials(choosingwisely.org), which source the Congressional Budget Office, as much as 30 percent of the cost of care in the United States can be attributed to unnecessary tests, procedures, medical appointments, hospital stays and other services that may not improve people's health. Moreover, CMS projects U.S. health care spending will reach $4.3 trillion, or 19.3 percent of the nation's gross domestic product, by 2019 if it continues at current levels.
"Physicians play a leading role in addressing problems with our nation's health care system," said Christine Cassel, M.D., president and CEO of the American Board of Internal Medicine Foundation, in the news release. "By identifying specific procedures or tests that may commonly be ordered, but (are) not always necessary to improving patient care, we're kicking off an important and overdue conversation about making wise choices in health care. Everyone -- providers, patients and others -- plays a part in being better stewards of the system's finite resources."