Choosing Wisely: Up for Discussion

Hospital-based doctors identify tests and procedures that may fail the “value” test

Editor’s note: In our September digital edition, the Journal of Healthcare Contracting published an article about Choosing Wisely®, an initiative to help physicians and patients engage in conversations about the overuse of tests and procedures, and support physicians’ efforts to help patients make smart and effective care choices. In that issue, we focused on issues of concern primarily to office-based physicians, such as internists, family physicians, allergists and endocrinologists. This month, we focus on input from hospital-based physicians – hospitalists, emergency physicians, anesthesiologists and orthopedic surgeons.

The concept of Choosing Wisely was originally piloted by the National Physicians Alliance, who through an ABIM (American Board of Internal Medicine) Foundation “Putting the Charter into Practice” grant, created a set of three lists of specific steps physicians in internal medicine, family practice and pediatrics could take in their practices to promote the more effective use of healthcare resources. Since then, 60 specialty societies have created lists of more than 300 “Things Physicians and Patients Should Question,” which provide specific, evidence-based recommendations physicians and patients should discuss to help make decisions about the most appropriate care based on their individual situation. (To view a complete list of those recommendations go to http://www.choosingwisely.org/wp-content/uploads/2013/02/Choosing-Wisely-Master-List.pdf.)