October 28, 2015
By Patricia Gabow, MD, MACP, et al
October 18-24 was RightCare Action Week. Like so many other “special weeks,” most people are probably unaware of it. But unlike many such campaigns, this one matters to every family’s wellbeing and safety. RightCare Action Week is a nation-wide activity sponsored by the Lown Institute, whose founder Bernard Lown, a prominent cardiologist, received, along with a fellow Russian physician, the Nobel Peace prize in 1985 for their establishment of International Physicians for the Prevention of Nuclear War. Today, Lown’s organization is aiming at a different threat—the American healthcare system’s paradoxical problem of giving many patients too much medical interventions , while also failing to give many of them the care they really need.
Unnecessary medical treatments and tests cost us huge amounts of money as individuals and society. Estimates for wasted spending on this overuse are as high as $800 billion a year. Even more importantly, unnecessary care can and does cause harm to patients.
Every day, in Denver and communities across the country, patients undergo surgeries that are not going to help them but nevertheless put them at risk. Patients with low back pain that would heal on its own in time undergo surgery that does not lessen their suffering, and all too often leads to more treatment. Patients receive unnecessary or duplicated CT scans, increasing their exposure to radiation and its risk of cancer. Children are given antibiotics that won’t cure their colds but can cause serious side effects and ultimately limit the effectiveness of antibiotics for everyone. Each year, tens of thousands of Americans are harmed or killed by unnecessary treatment.
There are many reasons for this overuse, including the way hospitals and physicians get paid; the limited time many physicians, especially primary care doctors, have for seeing their patients; and the poor and often difficult to understand information patients receive.
During RightCare Action Week, physicians in Colorado and across the country are joining together in a variety of actions that take aim at this overuse. These actions range from simple things, like counting the number of times they see a patient receive care he or she doesn’t need, or fails to get care that’s necessary. These counts will be sent to the Lown Institute, which will compile the numbers from around the country. Other actions include a pledge to use antibiotics more wisely, created by a group of pediatricians. They’ve already gathered hundreds of signatures from healthcare professionals around the country. We are part of this effort and we hope every healthcare professional takes his or her own actions to assure the right care.
Patients should take action too. Always ask why a test or procedure is being done. Ask what are the potential harms, or side effects, as well as the possible benefits; ask about alternative approaches; ask why a drug is being given. Most of all, make sure your doctor or nurse explains in a way that helps you understand your care.
Recently, the American Board of Internal Medicine (ABIM) Foundation began working with 70 different specialty doctors’ groups to develop a campaign, Choosing Wisely, which provides lists of tests and procedures that should prompt such discussions between patients and doctors. The list includes a wide range of tests, treatments and drugs, such as surgery for back pain, and brain scans for head trauma. The ABIM Foundation is partnering with Consumer Reports to help patients get the information they need.
We are all partners with our physicians in our own care. We ask all physicians and healthcare professionals to join the movement. Support the right care for everyone. If every patient and every doctor commits to the right care, we can make healthcare better and improve the nation’s health.
Patricia A. Gabow, MD, MACP
Irene Aguilar, MD
Richard Albert, MD
Brandon Combs, MD
Richard Dart, MD
Mark Earnest, MD
Simon Hambidge, MD
Lucy Loomis, MD
Paul Melinkovich, MD
Ernest “Gene” Moore, MD
Donald Murphy, MD
Connie Price, MD
Philip Stahel, MD