The AAFP now is offering videos that include key communication concepts to accompany three of the recommendations on its Choosing Wisely list of 15 procedures or tests(www.choosingwisely.org) that physicians and patients should question.
The videos, which feature family physician and U.S. Preventive Services Task Force Co-vice Chair Michael LeFevre, M.D., M.S.P.H., of Columbia, Mo., were developed by the Academy to help physicians better navigate the difficult discussions that can take place regarding the following recommendations:
- Don't do imaging for low back pain within the first six weeks, unless red flags are present. (View the video.)
- Don't routinely prescribe antibiotics for acute mild-to-moderate sinusitis unless symptoms last for seven or more days or symptoms worsen after initial clinical improvement. (View the video.)
- Don't order annual electrocardiograms or any other cardiac screening for low-risk patients without symptoms. (View the video.)
In each video, LeFevre, who also is Future of Family Medicine professor, director of clinical services, and vice chair of the Department of Family and Community Medicine at the University of Missouri, Columbia, is shown talking with a patient about the test or procedure being considered. All of the videos follow a templated script that shows him exhibiting the following specific behaviors:
- summarizing the exam or procedure,
- eliciting the patient's concerns and questions,
- expressing empathy and fostering a sense of partnership,
- clearly explaining the rationale for the recommendation, and
- confirming agreement while overcoming patient barriers.
LeFevre also gives a brief video overview about the importance of the Choosing Wisely initiative.
The AAFP is an original member of the ongoing American Board of Internal Medicine Foundation campaign(www.choosingwisely.org) to help physicians curtail the practice of ordering unnecessary tests and procedures. The Academy is the only organization that has released recommendations during all three phases of the campaign, underscoring family physicians' long-term commitment to ensuring high-quality, cost-effective care for patients.
The Academy created all of its clinical recommendations through the AAFP Commission on Quality and Practice and the AAFP Commission on Health of the Public and Science, which evaluated and approved each item using sources such as reviews from the Cochrane Collaboration and evidence reports from the Agency for Healthcare Research and Quality.