Are Americans ready for rational care?

Some Americans worry that their health care will be rationed, that efforts to rein in health care spending will restrict their treatment choices.  Some Americans worry that unrestricted access to healthcare interventions not only raises costs but exposes Americans to unnecessary and often unrecognized risk.

Several physician led organizations have initiated projects to address overuse of care and to educate consumers and their colleagues about the difference between rationing and rational care.

Choosing Wisely by the American Board of Internal Medicine (ABIM) Foundation seeks to support physicians and patient choice of care that is evidence-based, doesn't duplicate care already received, and balances the risk against the benefit to the individual patient. To that aim, the campaign asks participating specialty societies to identify 5 practices that are common to their field but that may be overutilized.

Consumer Reports has partnered with the Choosing Wisely Campaign to help educate consumers about appropriate care and provides patient resources for several of the practices identified by the specialty groups.

The AMA Physician Consortium for Performance Improvement (PCPI) and The Joint Commission jointly sponsored a National Summit for Overuse to discuss the appropriate use of 5 specific interventions:

  • Heart vessel stents (percutaneous coronary intervention or PCI)
  • Blood transfusions (blood management)
  • Ear tubes (tympanostomy tubes) for brief periods of fluid behind the ear drum
  • Antibiotics for the common cold (viral upper respiratory infections)
  • Early scheduled births (early induction) without medical need

If you missed the PBS documentary on Money and Medicine, you can watch it at the link. It features some of the researchers of the Dartmouth Atlas project and their data on regional variations in care.

Are Americans nearing a "Tipping Point" in questioning the appropriateness of health care interventions? Are physicians taking the lead in this "Diffusion of Innovations"? Stay tuned.