Giving a child with a bad cough or an adult with sinusitis an antibiotic, getting a CT scan or MRI for low back pain, having a Pap test done every year…these are all examples of tests or treatments that are over-used and about which patients should have conversations with their providers before they are done. We all know that some tests and treatments, when done unnecessarily, can lead to further anxiety or harm.
So how do we address this issue? Patients need to be educated, sure. But so do physicians and hospitals, who order the inappropriate tests and procedures. And because economic incentives often influence these choices, we need to change those as well.
The ABIM Foundation’s started its Choosing Wisely campaign focuses on patients. The Massachusetts Health Quality Partners (MHQP) will be working to advance the Choosing Wisely campaign in the Commonwealth. Choosing Wisely is an effort to ensure patients are receiving evidence-based, effective care. The program compiles materials and resources patients can use to be more engaged in their care and have conversations about their care with their doctors and other care providers.
Going forward, the campaign plans to work with MHQP’s members, which include employers, health plans, consumers, and other interested parties, to raise awareness about specific procedures and tests patients should question.
There are many good reasons to be skeptical about the value of this approach. Change needs to happen at the physician level as well. So we’re particularly pleased that the campaign will also reach out to the Massachusetts Medical Society to disseminate resources about unnecessary care. Additionally, the campaign will work to integrate Choosing Wisely with MHQP’s statewide Practice Pattern Variation Analysis program, which provides the opportunity to educate providers directly about what tests and practices can cause problems and waste.
This campaign is a large step forward for making health care more efficient and coherent for patients and advancing the partnership that should exist between providers and patients when making care decisions. Many of us have been in situations where we are not sure if a test or treatment is right for us but we often don’t have the tools to speak up. Choosing Wisely can empower patients to be true partners in care.