On February 21, the ACR–along with 16 other national medical societies–released its list of Five Things Patients and Physicians Should Question in Rheumatology. I want to tell you about why the ACR participated in this effort, organized by the ABIM Foundation as part of its Choosing Wisely campaign.
Healthcare Reform: Read All About It!
The national discussion and debate about U.S. healthcare reform is pervasive. It seems not a day goes by that the ACR’s Rheumatology Morning Wire doesn’t include a related story, as decisions made by lawmakers and others make headlines daily. Turn on any news program and you’ll hear more opinions than you even knew existed on the subject—political pundits demonizing the other party for their proposed solutions, or for failing to come up with a viable solution.
We hear about healthcare reform from our patients, too. Although they may, at one level, be concerned about our society’s ability to sustain current healthcare spending, as individuals, many are worried about continued access to the medical services and therapies that are vital to their well-being.
As physicians, we have a unique voice to bring to this national dialogue. We know our patients and their needs better than any other participant in this discussion besides the patients themselves. While others argue about increasing the value of goods and services received for each healthcare dollar spent, physicians and health professionals are best equipped to share what actually works—and what doesn’t—so these dollars can be wisely spent.
Physicians and Other Healthcare Providers Weigh In
In January 2010, Howard Brody, MD, challenged the physician community to identify, publicize, and implement lists in each specialty that would “consist of five diagnostic tests or treatments that are very commonly ordered by members of that specialty, that are among the most expensive services provided, and that have been shown by the currently available evidence not to provide any meaningful benefit to at least some major categories of patients for whom they are commonly ordered.”1 Dr. Brody asserted that organized medicine has an ethical responsibility to help ensure that healthcare dollars are used wisely so all patients have access to necessary and appropriate healthcare. He also encouraged physicians to consider that the autonomous relationship between patient and physician could best be preserved by ensuring that physicians—and not government or others—take the lead in identifying and eliminating waste.
Some organized physician groups had already begun this important work. The ABIM Foundation’s Putting the Charter into Practice program was launched in 2009 to provide small grants to advance principles of professional commitment in medicine, including “improving patient access to high-quality care, practicing evidence-based care, and advocating for just and cost-effective distribution of finite resources.”2