The Choosing Wisely campaign is a good example of how doing things a little differently when possible can pay off in a big way.
The campaign, which is led by the ABIM Foundation, is trying to reduce the number of tests and procedures being performed, targeting those that may be overused and potentially causing patient harm.
A typical approach the ABIM Foundation could have used back when the campaign was beginning in 2011 would have been to form a committee to study the problem and then write a report. I'm not criticizing those efforts that do use that methodical approach, because that's often the best way to go about tackling the weighty issues found in medicine.
But the ABIM Foundation, as an affiliate of the American Board of Internal Medicine, used its unusual position of medical authority to bypass a lot of the procedural rigmarole and went straight to the physicans' ordering the potentially unnecessary procedures. The foundation asked physician medical societies to look in the mirror to identify within their areas of expertise five overused tests or procedures as a starting point for discussion between physicians' and their patients. And to underline their seriousness, they asked Consumer Reports to get involved by translating the lists into action for patients.
Nine societies jumped on board at the beginning of the effort and now in 2014 the number of societies that have agreed to participate has grown to 60, identifying more than 220 procedures that are candidates for scaling back.
In coming weeks, look for H&HN Daily's video interview with Daniel Wolfson, executive vice president and COO of the ABIM Foundation, in which he talks about measuring the success of the campaign and its expansion.
In a telephone interview yesterday, Curtis Sessler, M.D., president-elect of campaign participant American College of Chest Physicians, described how there hasn't been much resistance to the effort within the college he represents. "I think it is similar to a clinical practice guideline, although different in its development, in that it is a set of recommendations made by experts and based upon the strength of the research evidence," said Sessler, who holds several titles for Virginia Commonwealth University and its affiliates, including professor of medicine and medical director of critical care.
"People recognize that these recommendations are generally useful, but they are recommendations for the practicing physician and they're not mandated and they're not tied to any decrease in reimbursement or other negative consequences," he said.
Kudos to the Chest Physicians group and the other participating societies for taking steps that could reduce harm and save money.