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Physician Checklist Zaps Wasteful Spending

Joe Cantlupe, for HealthLeaders Media, October 27, 2011

But some physician groups are taking the checklist premise one step further, focusing on procedures that should be minimized or eliminated altogether.

One of the key proponents of such lists of wasted practices is Howard Brody, MD, at the Institute for Medical Humanities at the University of Texas Medical Branch at Galveston. “The myth that physicians are innocent bystanders merely watching health care costs zoom out of control cannot be sustained,” Brody wrote last year in the New England Journal of Medicine.

Brody suggests that each specialty society appoint blue-ribbon panels to create “top five” lists of diagnostic tests or treatments that are among the most expensive and generally do not provide much benefit.

Nancy Morioka-Douglas, MD, MPH, a clinical professor of medicine/community and family medicine at the Stanford University Medical School, and a member of the NPA, agrees that doctors must take control of costs, especially needless procedures.

Referring to Brody’s plan, Morioka-Douglas seeks a “call to action” among each medical specialty to generate lists of at least the top five commonly ordered diagnostic tests or treatments that provide “care of low value to patients, specifically if it carries risk that outweighs benefits.”

The NPA convened a Good Stewardship Working Group to identify overused clinical activities across three primary care specialties, internal medicine, and family practice.

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2 comments on "Physician Checklist Zaps Wasteful Spending"


Dr. Rob (10/27/2011 at 2:45 PM)
Unfortunately, much unnecessary care is driven by: 1.) patients wanting an "immediate" cure for their condition. IF they do not receive the treatment THEY think is required, from their Primary Care MD, they seek treatment elsewhere. Who will educate the consumer, when they are "educated by the media" to make their own informed decisions ? 2.) Many "wasteful" diagnostic test are a result of practicing "defensive medicine". Most MD's will be happy to stop ordering these tests when plaintiff attorney's, and their "expert witnesses" stop referring to them as "standards of care" in lawsuits. Who will educate them, and assume the liability?

Karyn (10/27/2011 at 2:25 PM)
Nice job. How about not giving out controlled substances like candy. Lots of post op patients get 30 - 60 or more Vicodin, Oxycontin, etc and use between 5 and 7. Some of the problem is the 3rd party payors only allow for the docs to write a minimum of 30. This leads to over use. abuse and how to dispose of what was not used. How about a smaller amount with a refill.