Past Letters

In Response To: Are Docs Choosing Wisely?

On April 15th Jordan Rau of Kaiser Health News published a thoughtful article examining the Choosing Wisely campaign. This type of analysis is a critical part of the transparent, honest dialogue about the issues of unnecessary medical care that we have sought to encourage since launching the campaign. That said, we think it is unfortunately... Read more »

It’s About the Conversation

There is an interesting conversation taking place around Choosing Wisely® and a recent JAMA study by Pearson and Gliwa. It’s heartening to see that the campaign is doing what it was always meant to do – spark conversation. In their study, Gliwa and Pearson sought to “evaluate the role that evidence on benefits, risks, and... Read more »

Response to JAMA Internal Medicine Commentary

The Choosing Wisely campaign was recently criticized for lacking a solid methodological approach in an editorial in JAMA Internal Medicine by Deborah Grady, Rita Redberg and William Mallon. As such, we wanted to clarify the procedures that all of our specialty society partners have followed in creating their recommendations of tests and treatments that physicians... Read more »

Response to New England Journal of Medicine Choosing Wisely® Article

I thought the authors of the recent New England Journal of Medicine article, “Choosing Wisely — The Politics and Economics of Labeling Low-Value Services” presented the campaign in a thoughtful and balanced manner. On one hand, I was pleased with how the campaign was depicted—particularly the authors’ praise for the way it carefully created a... Read more »

Choosing Wisely®: A Stunning Moment

Every time I am invited to speak about the Choosing Wisely campaign, I ask the audience to raise their hands if they have witnessed or heard of unnecessary care delivered to patients, themselves and/or their family members. Usually, about three-quarters of them raise their hands. I then ask if they have witnessed or heard of... Read more »

Trust and Conflicts of Interest

I have been thinking a lot about the “trust” that needs to exist between the public and institutions, and what the repercussions of losing that trust are. After the Enron scandal, public trust was lost in corporations and the accounting industry (which in turn had a negative effect on the financial markets). To ensure the... Read more »

An Unexpected Reaction to Choosing Wisely® List at #ASTRO2013

I had the honor of speaking at the American Society for Radiation Oncology’s (ASTRO) annual meeting in Atlanta, Georgia on September 23. One of the goals of my session was to announce ASTRO’s Choosing Wisely list of five tests and procedures that patient and physicians should question. Actually, Michael Steinberg, MD, chair of the board... Read more »

Purpose vs. Payment

The 2013 ABIM Foundation Forum was entitled “Purpose vs. Payment:  Motivating Change in Health Care.”  The title was, of course, a false dichotomy. Going into the meeting, I was pretty sure that the collective answer would be “both, of course!” But as the animated and spirited conversations among the participants continued over the three-day meeting,... Read more »

Adventures in Imaging

I was turning a ripe old age and wanted to improve my physical conditioning. My program included hoisting two 15-pound dumbbells and two sets of twenty sit-ups. This exercise, intended to preserve my last trace of youth, resulted in a self-inflicted injury of my left elbow. After a very uncomfortable month, I relented and sought... Read more »

A Consequence of Choosing Wisely®

In rural Maine, Choosing Wisely brought primary care and specialists together to discuss the recommendations – a positive, unintended consequence of the campaign. Early in the development of the campaign, we learned that physicians did a lot of finger-pointing around who was responsible for overuse. The primary care physicians blamed the specialists and the specialists... Read more »