Can Doctors and Patients Choose Wisely?

I applaud the society of medical professionals for trying to accomplish cohesion and efficiency within an industry that is having a significant effect on our country’s economy. Health care costs are rising and severely affecting the financial stability of current or prospective seniors aging into Medicare.

The Choosing Wisely Campaign is a project of the ABIM Foundation, medical specialty societies and Consumer Reports. At the heart of the campaign are a series of lists of tests and procedures to question – developed by the societies. Each society came up with a list within their domain of practice.

These ‘lists’ are comprised of overused tests and treatments, that for the beneficiary can be devastatingly expensive and in many cases unnecessary. Do doctors really care and want the best for their patients? I would like to think that they do, and this initiative is doing wonders in restoring my trust. Here’s the problem however…. The medical field’s mantra, if you will, is to provide the best possible care for patients both ethically and professionally. If that’s the case then why are doctors ordering multiple tests or treatments for a patient that when looking at the evidence, doesn’t really help them or provide any new information regarding their illness? I understand they want to do all that they possible can for the patient, but at what cost? It does not cost doctors anything. For the patient however, they are now starring down a barrel made of bills (expenses for providing care) that most cannot afford. So again, I ask, “how does going the extra mile help?”

In a lot of cases, getting a second or third opinion has saved millions of lives. (Not to mention, subsequently either adding or subtracting to the ever increasing cost of providing health care in this country). But many of those second and third opinions have also provided nothing that benefits the patient. The only thing new here is the fact that a patient now has to pay for a procedure or test/treatment they could have done without. The key to solving this conundrum is to find an effective way to develop and execute combined decision making. Doctors and patients must find a better way to communicate their concerns, albeit procedural or financial. This common understanding is truly necessary in order to get past this complication, and increase efficiency without decreasing the quality of care provided.

An interesting point is addressed by this article concerning viewers’ interpretation of this initiative as a means to decrease access to quality health care. For the record IT IS NOT. Choose Wisely’s mission however, is to use communication as a means to determining whether certain or often used tests/treatments are relevant and necessary for the patient. If the medical industry as a whole can reduce health care costs without affecting quality of care provided, it is a win win for both the patient (less medical expenses) and doctors (less paper work and hassle to get insurance companies to cover said treatments provided). Decreasing the cost of health care provided as a nation could potentially save this country billions.

That being said, this potentially new surplus of funds could be used to increase reimbursement rates for social insurances like Medicare or Medicaid, which eventually would increase the quality of care delivered across the country. Doctors would no longer resist the urge to turn away new patients if they have government funded insurance because the reimbursement rates for services rendered would be acceptable. As of right now, they are not, and Medicare beneficiaries are paying the price for it.

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