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Berwick: Zapping Overtreatment, Costs Takes 'Courage'

Cheryl Clark, for HealthLeaders Media, August 1, 2013

Each physician group's "Top Five would be a prescription for how, within that specialty, the most money could be saved most quickly without depriving any patient of meaningful medical benefit," Brody wrote. He suggested that arthroscopic surgery for knee osteoarthritis and many common uses of CT scans, should start the list.

Nine specialty groups' lists launched the project in April, 2012 with their selection of 45 procedures, tests, or drugs that patients and their doctors should seriously question before undergoing because of the potential for needless cost, waste, and harm.

In March, the ABIM Foundation grew that list from nine specialty groups to 26, and from 45 procedures, drugs and tests to 130, some of which groups felt so strongly about, they duplicated.

But there's more, Wolfson says. Later this month and through the fall, The ABIM Foundation will grow that list again, adding another 30 specialty groups' top fives, for a total of 250 procedures and tests that doctors and patients should avoid.

The ABIM Foundation collaborates with Consumer Reports to take the message to patients as well, to reassure them that they are not necessarily getting poor or no care when they don't receive worthless or harmful treatments.

"We've elevated the conversation and made it legitimate to talk about, and get away from the hysteria that this is about rationing and death panels," Wolfson says. He points to this week's New York Times article about efforts to stop calling certain benign conditions "cancer," such as ductal carcinoma in situ.

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