The Search for the Holy Grail: Doing More with Less
Likewise, the failure of physicians and patients to make the right choices puts the financial well-being of the United States at risk. Physicians are confronted with numerous tests or procedures that can be applied to our patients. We frequently do not choose wisely because we do not consider the cost in relationship to the benefit to the patient. Rather, physicians tend to select what is most expedient or new or likely to be of financial benefit to them. Approximately 18% of the US gross domestic product was spent on healthcare in 2011. It is estimated that 21% to 34% of this expenditure is wasted.1 Overtesting accounts for $210 billion of the $2.2 trillion the United States spends on healthcare each year.2 Options to control these costs are limited. One approach is to reduce reimbursement to providers and hospitals for the care being provided. Another and more appealing alternative is to reduce the waste.
The American Board of Internal Medicine Foundation has created Choosing Wisely, in which the American Board of Internal Medicine has partnered with 9 other societies to help physicians better manage our healthcare dollars. The stated goal is “while managing the needs of individual patients, physicians are required to provide health care that is based on the wise and cost-effective management of limited clinical resources”.3 Each of the societies has developed recommendations for certain disorders in which cost-effective decisions can be made between the patient and the physician. All of these recommendations can be found on choosingwisely.org.
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–Thomas Boyer, MD
–This article originally appeared in the December 2012 issue of The American Journal of Medicine.
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