The American Board of Internal Medicine (ABIM) established the ABIM Foundation to advance professionalism in improving healthcare. The foundation initiated the Choosing Wisely campaign [www.choosingwisely.org] in April 2012 to promote conversations that help physicians guide patients in selecting care that is supported by evidence, not duplicative of other tests or procedures, not harmful, and truly necessary. In order to achieve this, national organizations representing medical specialists were asked to identify five common tests or procedures whose necessity should be questioned.
John Bulger, DO, MBA, SFHM, chief quality officer at Geisinger Health System in Danville, Pa., chaired SHM’s Choosing Wisely recommendations committee. He says the “proximal concern over these tests may be the unnecessary cost of the test itself, [but] there are other unintended consequences.
“False positive or false negative results of unsupported testing may cause unwarranted emotional harm for the patient or may give a false sense of security,” he adds. “The latter may also be true for physicians who may fail to further investigate other ailments based on a previous false negative test. Tests ordered with little evidence tend to lead to more tests ordered with little evidence.”
To date, more than 60 specialty societies and 17 consumer groups have joined the Choosing Wisely effort, citing more than 300 potentially harmful tests and procedures that physicians should discuss with patients. New lists will be published throughout 2014.
—Karen Appold