Past Letters

The Case for Choosing Wisely® and American College of Emergency Physicians

The nine specialty societies that were part of the launch of the Choosing Wisely campaign in April were courageous in identifying medical tests and procedures that physicians and patients should question. More than 20 additional societies will be issuing lists in 2013. They should be commended for their leadership and putting the interests of their... Read more »

Choosing Wisely®: It is All About the Conversation

From our communications research, we’ve learned that one of the most difficult challenges physicians say they face in talking to their patients about why a test or procedure is not necessary or will not alter a treatment plan is they simply don’t have enough time during a regular office visit. They often say that if... Read more »

The Words Used to Talk About Use of Resources: What Do They Tell Us?

The words we use to talk about the use of health care resources makes a difference in how we engage physicians, clinicians and patients in thoughtful discussion around the economic sustainability of the current health care system.  These conversations must happen — without hysteria and political motivation. We need attitudinal and political changes before we... Read more »

Stuck in the Muddle of Fee-For-Service Medicine

I was once at a meeting where I heard a national health business leader liken providing additional incentives in a fee-for-service system to putting broccoli on a Big Mac. His point — a volume-based reimbursement system can’t be cured by some incremental bonus plan. While we continue to structure our delivery system around fee-for-service, health... Read more »

The $640 Billion Question

On May 18, Victor R. Fuchs, PhD and Arnold Milstein, MD, MPH published a perspective in The New England Journal of Medicine, titled “The $640 Billion Question –Why Does Cost-Effective Care Diffuse So Slowly?”  I highly recommend reading it. $640 billion is the amount of money saved if health care costs were lessened by 20%... Read more »

My EKG

I rarely get sick and have no known disease. I’m fit as a fiddle for an aging male. I jog four times a week and have strong vital signs (blood pressure is 120/70). I have no family history of heart disease. Besides complying with adult screening recommendations and vaccines, I only see a doctor when... Read more »