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Berwick: Zapping Overtreatment, Costs Takes 'Courage'

Cheryl Clark, for HealthLeaders Media, August 1, 2013

The former acting head of the Centers for Medicare & Medicaid Services lauds efforts such as the Choosing Wisely campaign, which aim to reduce medical interventions "for which the risks outweigh the benefits."

At the American Hospital Association's Leadership Summit last week, Don Berwick, MD, called out the "11 scary monsters" lurking under the healthcare industry's bed. Can you guess which one he says is the worst one of all, the Godzilla thwarting improvements to quality care?

Pat yourself on the back if you said "excess," or "overtreatment." These are drugs, tests, or procedures that "don't help, but subject people to risk." Berwick, former acting administrator of the Centers for Medicare & Medicaid Services, says spending on American healthcare is 40% more than it needs to be.


See Also: Berwick Names 11 Monsters Facing Hospital Industry


But if he had his audience trembling in their seats, worried about their jobs, Berwick may have scared a few listeners even more by talking about "the courage" he's seen in three efforts underway to slay those beasts.

The first, he said, is that "The ABIM (American Board of Internal Medicine) Foundation has been sponsoring the Choosing Wisely campaign."

The second, "Shannon Brownlee and Dr. [Vikas] Saini [of the Lown Institute] have been doing the important work…They're taking a closer look at overtreatment and it will be scary what they find." [Note: Berwick is a volunteer member of the Lown Institute Advisory Council.]

And third, he said, "I'm thrilled that Rich [Umbdenstock, president and chief executive officer of the American Hospital Association] is now telling me that the AHA is taking on the agenda of appropriateness [of care]. That's now on the AHA agenda."

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