Category Archives: Choosing Wisely

Cheers to a Great Year!

To the Housestaff, Faculty, Fellows, and Students,
As our year with you ends, we want to take a moment to thank you. Thank you for your dedication, your professionalism, your curiosity, and your commitment to the best quality patient care. Thank you for being expert clinicians, accomplished researchers, and outspoken advocates for your patients. Thank you for helping open a brand new hospital, for being the best recruiters in the world, and for rising to the challenge of potpourri. Thank you for supporting us, for standing by our side, for voting on the case challenges, and for reading this blog! In short, thank you, for an amazing year – we know that next year will be even better!
– Your 2014-2015 Chief Residents (Punag, John, and Kate)

The Myth of the Demanding Patient

Healthcare spending projectio(Image from the Commonwealth Fund)

You’ve heard it before – the cost of healthcare is too high, and it keeps on rising! Some physicians tend to place responsibility for high medical costs more on “demanding patients” than themselves. However, new research in JAMA Oncology suggests otherwise, noting that patient “demands” directly account for a negligible change in physician behavior and thus expenditure. Take a look at the original article, or, for a more colorful read, the editorial “The Myth of the Demanding Patient.”

Choosing Wisely – Infectious Diseases Society of America

The Infectious Diseases Society of America (IDSA) last week released its list of tests or procedures whose necessity should be questioned, as part of the ABIM Foundation’s Choosing Wisely initiative.

The recommendations are as follows:

1. Don’t treat asymptomatic bacteriuria with antibiotics.

2. Avoid prescribing antibiotics for upper respiratory infections.

3. Don’t use antibiotics for stasis dermatitis of lower extremities.

4. Avoid testing for a Clostridium difficile infection in the absence of diarrhea.

5. Avoid treatment with antibiotics for mitral valve prolapse.

Antibiotics: when you need them—and when you don’t

It’s the middle of winter, with no end in sight. A 28 year old male arrives in your primary care clinic with no past medical history and one complaint: a stuffy nose. For the last 3 days, he has had sinus congestion, a mild cough, and associated headache. He denies fever, sick contacts, myalgias, etc. You suspect a viral infection, noting that the patient should improve without antibiotics, but he insists. He must have antibiotics today, so that he can return to work! Do you give in and send him out with a Z-pack?

Consumer Reports has joined with the ABIM and the Choosing Wisely Campaign to help educate patients about when, where, and how to use antibiotics, in an effort to prevent, as they note, unnecessary harm.

Take a look at the patient resources below – if you like them, print them out and display them in your practice. It just might make your next conversation a bit easier…

The PDF and the poster may help with patient education!