It may seem strange to have a physician promote less medicine, but that’s exactly what the Choosing Wisely campaign is about.
Started by the American Board of Internal Medicine Foundation, the campaign encourages “physicians, patients, and other healthcare stakeholders to think and talk about medical tests and procedures that may be unnecessary.”
In other words, less may indeed be more in certain cases. Why might this be true?
There are some estimates that nearly 20% of healthcare costs in the United States may be considered “waste” in that they don’t create value for the patient. A large portion of such waste may comprise testing and treatments that haven’t been shown to improve outcomes.
Furthermore, some medications and diagnostic testing may actually place patients at increased risk of harm.
In support of Choosing Wisely, Akron Children’s pediatric hospital medicine group is promoting these 5 recommendations:
- Don’t order chest X-rays in children with uncomplicated asthma or bronchiolitis (a viral infection of the lungs)
- Don’t routinely use bronchodilators (an inhaled medication that helps open up the airways) in children with bronchiolitis
- Don’t use systemic corticosteroids (a medication that can help reduce inflammation of the lungs) in children under 2 years of age with an uncomplicated lower respiratory tract infection
- Don’t routinely treat gastroesophageal reflux disease (GERD) in infants with acid suppression therapy
- Don’t routinely use continuous pulse oximetry (a device that monitors and estimates oxygen saturation of the blood) in children with acute respiratory illness unless they are on supplemental oxygen
This initiative embodies the approach that Akron Children’s will continue to use in this time of rapid change in healthcare. It aims to promote safe patient care while at the same time using our resources wisely.
We encourage parents to be active participants in their child’s medical care by asking questions about diagnostic and treatment options. Don’t be afraid to ask why a test or treatment is necessary or whether there’s a safer alternative.
Success will require education and communication among physicians, nurses and families.
Dr. David Chand is a pediatric hospitalist and Lean Six Sigma deployment leader at Akron Children’s Hospital. He has a special interest in eliminating waste in healthcare and uses Lean Six Sigma principles to improve patient care and efficiency.