Past Letters

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 »

One Doc’s Reactions to Choosing Wisely®: An Interview with Dr. Blair Erb

Dr. Blair Erb of Bozeman Deaconess Health Group, located in Bozeman, MT, is a Trustee of the American College of Cardiology and sits on the Clinical Quality Committee steering committee. He is board certified in Internal Medicine and in Cardiovascular Disease. His special interests include echocardiography, valvular heart disease and risk factor modification. Dr. Erb... Read more »

Selling Proton Therapy to the Public: High Costs Without Benefit

Arriving in a train station in a Northeast city the other day, I was struck by the number of advertisements for proton therapy at a local academic medical center (AMC) plastered throughout the station and in local subways. The ads feature a bicycle racer with the tag line: “THE WIND IN YOUR FACE IS WORTH... Read more »

Why Professionalism Matters: A Patient’s Point of View

As an employee of the ABIM Foundation, I’ve batted around the phrase “medical professionalism” for several years but it didn’t really hit home for me until I encountered it – and the lack thereof – as a patient. Over the past six months, I’ve logged a few miles in the frequent patient program. I underwent... Read more »

Incurable and Irreversible

My Argentinean mother-in-law is 95 years old and suffers from advancing dementia. She has lived with my sister-in-law for the last eight  years and both of her daughters are considered her caregivers. A person comes to the house for about seven hours a day to assist her in activities of daily living. After suffering what... Read more »