We’ve heard from a number of physicians across the country that they are beginning to think through ways to advance the Choosing Wisely campaign. They are embracing the recommendations from the specialty societies and exploring how conversations between physicians and patients about reducing overused or wasteful tests and procedures can be embedded in their practices. More than 30 specialty societies have joined the effort to date, while one society continues to discuss the pros and cons of participating.
Since the launch of the campaign in April 2012, more than 55 peer-reviewed journal articles have included mention of the Choosing Wisely campaign. Much of what has been written in the blogosphere and trade publications has been favorable to the campaign.
The following are five reasons I think can be attributed to this positive reaction. The number five also matches the number of recommendations made by specialty societies taking part in the campaign originated by the National Physician Alliance and described by Howard Brody in hisNew England Journal of Medicine article “Medicine’s Ethical Responsibility for Health Care Reform — The Top Five List”.
1) The campaign emphasizes the patient-physician relationship and conversations between them about overused medical tests and procedures where the risks outweigh the benefits. Physicians welcomed this renewed emphasis on the relationship and communication between patients and physicians.
2) Physicians also welcomed their specialty society taking a leadership position, particularly on issues of determining appropriateness of health care and identifying waste in the system, which can place their patients in harm’s way.
3) The campaign is a refreshing change from the polarizing and sometimes toxic environment that we sometimes see in health care discussions. The campaign has allowed for more thoughtful conversations about the need to create a more sustainable health care system.
4) Choosing Wisely has reinforced the notion that removing waste – things that don’t add value to the patient – improves quality and safety and in most instances, reduces costs.
5) Physicians don’t have to have a divided self as described by Parker Palmer in his book,Courage to Teach. Many physicians say they are asked to perform tests and procedures they knew were wasteful, but feel they needed to accommodate patient requests. Their inner being – their set of professional values don’t match with their outward behavior. The divided self produces psychological pain. Physicians are beginning to have the power, backed by their credible and prestigious specialty societies, to say more isn’t necessarily better.
These are just my five reasons why I think Choosing Wisely is helping move the conversation about managing resources in the right direction, but there are probably others. What do you think are other reasons the campaign resonates with physicians?