Choosing Wisely Campaign Grows Wider and Deeper


John Marcille

“Our primary objective is to change the American public’s attitude that more is always better and physicians’ attitudes about their responsibility to be good managers of resources on behalf of their patients.”

Before you run for the exit, this is not a statement by an HMO executive circa 1996. It is, rather, the defense of an ever-widening and influential effort by doctors to police themselves through the Choosing Wisely campaign. It is offered by Daniel B. Wolfson, chief operating officer of the American Board of Internal Medicine Foundation, whose parent organization, the American Board of Internal Medicine (ABIM), spearheads the movement.

We noted in June 2012 how much of a game-changer this might be (http://tinyurl.com/choice-article). On February 21, the ABIM not only updated the list of overdone procedures (from 45 to 130), but updated the list of member organizations, adding 17.

You can get the lists here (http://tinyurl.com/doc-lists), but just to give you a taste:

  • The American Academy of Pediatrics says that children need not necessarily be given CT scans for minor head injuries. It recommends monitoring the patients before making that determination.
  • The American College of Obstetricians and Gynecologists says that annual Pap tests for women 30 to 65 need not be given. The tests should be given every three years.

Health insurance executives have been somewhat mute concerning this effort, perhaps recalling the visceral public reaction to rationing, perhaps thinking, Is it really worth it to deny someone a relatively inexpensive prostate-specific antigen test or mammogram? Maybe the answer, thankfully and at long last, is moot.

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