Patient Safety and Professionalism

March 12–18 marks Patient Safety Awareness Week, an important initiative of the National Patient Safety Foundation (NPSF) aimed at raising awareness about patient safety among health care professionals and the public.

At the ABIM Foundation, we’ve long thought of patient safety through the lens of professionalism. Medical Professionalism in the New Millennium: A Physician Charter articulates the principles and commitments physicians should aspire to embody in practice, such as continuously striving to improve the quality of care they deliver to patients and upholding scientific standards.

More recently, the Foundation has focused its efforts on the Charter’s call for physicians to take responsibility for “…scrupulous avoidance of superfluous tests and procedures.” In partnership with Consumer Reports, 80 medical specialty societies and dozens of consumer groups, we’ve led the Choosing Wisely® campaign to encourage and support clinicians and patients in conversations about avoiding unnecessary tests and treatments.

Choosing Wisely draws inspiration from the Hippocratic Oath and its call for physicians to “First, do no harm.” If patients receive a test or treatment they did not need, at best they suffer no major long-lasting consequences beside time lost or out-of-pocket cost. While these are not trivial concerns, the greater fear is the harm that could be inflicted – such as physical pain or an invasive procedure – due to an unnecessary test or treatment that may not have been indicated in the first place.

Medical specialty societies participating in Choosing Wisely have collectively published nearly 500 recommendations regarding tests and treatments they say may be overused and should be discussed. Consumer Reports has worked with many of these societies to develop more than 100 patient-friendly brochures that explain the risks, benefits, and questions patients should ask their clinician for many common conditions, such as low-back pain or a cold.

While publishing this information is a critical step in our awareness and education efforts, we know in order to be truly successful we need to focus on putting Choosing Wisely recommendations into practice. One way this is already happening is through the seven Choosing Wisely grant projects that are each addressing at least three areas of overuse. These projects are supported by the Robert Wood Johnson Foundation (RWJF).

For example, Los Angeles County (LAC)+USC Medical Center has made dramatic reductions in pre-operative visits and tests for patients undergoing cataract surgery. This means fewer patients will be subjected to unnecessary radiation exposure or run the risk of “incidental-omas” that could lead to even more tests they don’t need.

By educating clinicians and patients not just about the tests and treatments they should avoid but how they can talk with one another to share in the decision-making process, we can reduce inappropriate care and make care safer.

The ABIM Foundation is proud to support Patient Safety Awareness Week and the work of the National Patient Safety Foundation, and encourages all to join us in Choosing Wisely.

Daniel B. Wolfson
EVP & COO, ABIM Foundation