Past Letters

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 »

It Was Just a Cough: Wasteful and Potentially Harmful Medicine

Over his recent winter break, my 26-year-old son went skiing in Idaho. Fully insured on COBRA, he went to a free-standing urgent care facility in his small resort town for a cough. No culture was taken and he was never asked if he was taking any medications (which he is), but he did receive the... Read more »

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 »