Making Wise Choices

As our nation struggles to reform a health care system beset by ineffective, wasteful and expensive care, independent initiatives are provoking physician and patient engagement to encourage conversations about appropriate care.

The Choosing Wisely campaign, an effort spearheaded by the American Board of Internal Medicine (ABIM) Foundation, seeks to incorporate these kinds of conversations, which emphasize the importance of individualized care with shared decision-making, into standard practice.

According to the ABIM Foundation, the campaign is part of a wider effort to “help physicians be better stewards of finite health care resources.” Originally, ABIM partnered with the National Physicians Alliance, which came up with the concept of having three primary care specialties identify the top five tests or procedures that are commonly performed, but the necessity of which should be questioned and discussed.

Roughly a year ago, a group of physicians and public health experts published an analysis of these lists in the Archives of Internal Medicine, which found that eliminating unnecessary use of just those 15 procedures and tests would reduce annual health care costs by more than $5 billion.

ABIM has since broadened the scope of the recommendations to include a wide range of specialties, each of which identifies the Five Things Physicians and Patients Should Question and provides key recommendations for treatment alternatives. The lists include evidence-based recommendations for patients and physicians to discuss in the course of educated decision-making.  The goal is to spark an open dialogue between patients and physicians about the benefits, drawbacks and necessity of many frequently ordered tests or treatments.

Christine Cassel, M.D.

The campaign continues to develop partnerships with other physician associations, as well as with consumer-oriented groups, including Consumer Reports, which is leading the effort to educate consumers about what it means to choose wisely.

Last month, ACHP hosted a webinar in which Christine Cassel, M.D., president and CEO of the American Board of Internal Medicine and ABIM Foundation, discussed the role of health plans in promoting the campaign among physicians and provider groups. The campaign will continue to support conversations among physicians and patients around overutilization of services, and ACHP plans remain at the forefront of this dialogue.

The information being produced through the campaign and the ensuing shift toward critical and resourceful thinking about health care will be of utmost importance as we move into the turbulent waters of health law implementation.

Patricia Smith, President and CEO, ACHP


Following are links to some additional resources related to the Choosing Wisely campaign and efforts to reduce waste in the health care system:

Photo courtesy of U.S. National Library of Medicine.