Past Letters


My Lean and Mean Physical Exam

My routine physical represented a “lean,” less-wasteful physical; it focused on high-yield tests and the most beneficial exam.

Choosing Wisely® – Building Bridges Across Care

When the ABIM Foundation launched the Choosing Wisely campaign, we created a set of operating principles for our society partners and gave them guidelines to help them develop their lists. Among these guidelines was a stipulation that recommendations needed to be within the control or purview of that specialty. Each society was asked to take... Read more »

A Sacred Moment Ruined

On July 28, my wife’s brother, Marcos, died from cancer at the age of 58. He died at home under hospice care and was heavily sedated over the last weeks of his life. Marcos had undergone two chemotherapy regimens and one experimental treatment. His doctor was exemplary – she provided the best treatment options yet... Read more »

Docs Call Foul on Mark Cuban

An article in Forbes magazine entitled “Mark Cuban Doesn’t Understand Health Care” highlighted a series of tweets sent out by Mr. Cuban telling his 2.8 million followers to obtain quarterly blood tests in order to “have a baseline of your own personal health.” The Forbes piece focused on the “problems with Cuban’s argument” and included... Read more »

Choosing Wisely®: It’s a New Dawn, It’s a New Day

I recently attended a presentation by Mark Bonchek of thinkORBIT where I was inspired to reflect on the past three years of Choosing Wisely® and how the campaign reflects a cultural shift both in society at-large and in the way businesses operate. This shift has roots in self-determination theory, complexity theory, co-creation and digital strategies... Read more »

Choosing Wisely®: From Engagement to Implementation

A recent article challenged the Choosing Wisely recommendations around routine stress testing before low-risk surgeries. The article, “Stress Testing Before Low-Risk Surgery: So Many Recommendations, So Little Overuse” suggested the campaign’s partners focus on services with “high baseline rates of inappropriate care.” In her Editor’s Note in the same issue, Rita Redberg, MD, called for... Read more »

V.I.P. Syndrome Can Lead to Bad Care

A section of the tabloid, US Magazine, called “Stars – They’re Just Like Us”, shows pictures of celebrities doing mundane activities like walking the dog or taking out the garbage. This helps to remind us that, just like the average Joe, they walk their dogs and take out the garbage and— because they are people,... Read more »

Professionalism as a Means for Improvement

Jeffrey Kullgren, MD, MS, MPH, a general internist and researcher from VA’s Center for Clinical Management Research and the University of Michigan Medical School has a method for implementing Choosing Wisely® recommendations. He relies on a behavioral economics technique referred to as “precommitment” which, in this instance, calls upon physicians to make choices rooted in... Read more »

When Self-Promotion Crosses into Unprofessionalism

As a physician, is it possible to remain professional and market yourself? While it is understandable that physicians and physician researchers need to promote themselves to get jobs, patients, research grants etc., it should never come at the cost of patient care or trust.need to be able to trust that their physician is competent and... Read more »

The More Things Change, the More They Stay the Same

I recently met with former CEOs of prepaid group practices (PGPs) that were part of the early years (1984-2000) of the HMO Group—now the Alliance of Community Health Plans—a coalition of not-for-profit, pre-paid group practices. (I was the first president and CEO.) One of the most notable accomplishments of this alliance back then was the... Read more »