Choosing Wisely Campaign Aims to Curb Medical Spending

The American Board of Internal Medicine, in collaboration with Consumer Reports, has recently launched an initiative called Choosing Wisely, which aims to reduce unnecessary medical treatments. Some organizations have estimated that up to one-third of all medical spending in the United States is unnecessary; this spending includes unnecessary hospitalizations, money spent on unproven treatments and ineffective new drugs, and futile end of life care. More specifically, there are often EKGs performed routinely during physicals even when there are no signs of heart trouble in the patient, and MRIs are taken frequently whenever a patient complains of back pain.

According to Roni Caryn Rabin of the New York Times, who recently wrote about the Choosing Wisely initiative, specialty-specific medical organizations are beginning to crack down on unnecessary testing. For instance, “the American College of Cardiology is urging heart specialists not to perform routine stress cardiac imaging in asymptomatic patients, and the American College of Radiology is telling radiologists not to run imaging scans on patients suffering from simple headaches. The American Gastroenterological Association is urging its physicians to prescribe the lowest doses of medication needed to control acid reflux disease.”

The Choosing Wisely initiative has gained momentum by getting the backing of 9 professional medical societies already. Those organizations include:

• American Academy of Allergy, Asthma & Immunology
• American Academy of Family Physicians
• American College of Cardiology
• American College of Physicians
• American College of Radiology
• American Gastroenterological Association
• American Society of Clinical Oncology
• American Society of Nephrology
• American Society of Nuclear Cardiology

These societies, which represent approximately 374,000 physicians, are about to be joined by eight additional medical societies that have agreed to help participate in the campaign in 2012. Those organizations are:

• American Academy of Hospice and Palliative Medicine
• American Academy of Otolaryngology—Head and Neck Surgery
• American College of Rheumatology
• American Geriatrics Society
• American Society for Clinical Pathology
• American Society of Echocardiography
• Society of Hospital Medicine
• Society of Nuclear Medicine

“Overuse is one of the most serious crises in American medicine,” said Dr. Lawrence Smith, physician-in-chief at North Shore-LIJ Health System and dean of the Hofstra North Shore-LIJ School of Medicine. “Many people have thought that the organizations most resistant to this idea would be the specialty organizations, so this is a very powerful message.”

Read more about the initiative at www.choosingwisely.org.