November 15th, 2018
The Lown Institute and the American Family Physician are collaborating on a new series of commentary articles called the “Lown Right Care” series. This series applies the framework of right care — evidence-based, patient-focused, high value care — to common clinical situations. Each article provides an example of a common clinical situation where there there are opportunities to avoid overuse by not doing things, and to improve underuse by incorporating things into routine practice.
“At its core, the clinicians role is to be a trusted guide in the face of shared uncertainty. And to play that role, we clinicians must recognize that the most important dimension of our care of the patient is the strength of our relationship to the patient,” write authors Dr. Vikas Saini, president of the Lown Institute, and Dr. Kenny Lin, Professor of Family Medicine at the Georgetown University Medical Center.
The first case scenario in the series, written by Dr. Alan Roth, Professor of Family Medicine at the Jamaica Hospital Medical Center, Dr. Andy Lazris, family physician practicing in Columbia, MD, and Dr. Sarju Ganatra, cardiologist at Lahey Hospital & Medical Center, identifies overuse in cardiac testing.
The authors identify several types of overuse in this area, such as screening asymptomatic patients with electrocardiography, inappropriate cardiac imaging, and stress testing in patients with low probability of coronary artery disease, that often lead to overtreatment, increased cost, and patient harm.
The amount of clinical decision-making that is discretionary is extremely high and practicing clinicians need resources to help navigate this channel more easily. We are excited to present this new series as one of these resources!