The Robert Wood Johnson Foundation (RWJF) recently awarded the American Board of Internal Medicine Foundation (ABIM) a $4.2 million grant to continue promoting its Choosing Wisely program intended to reduce the incidence of needless tests and treatments by U.S. health care providers.
Needless tests are a huge driver of wasteful healthcare spending. A 2012 report by the Institute of Medicine found that 30 percent of healthcare dollars were wasted, with “unnecessary services” the biggest type of waste. A whopping $210 billion is flushed away annually in this way, the report estimated.
Doctors and patients are both part of the problem. Through the media, patients have become so familiar with exotic tests and treatments that it often seems as if every test is justified. Meanwhile, a raft of news reports and studies have documented how doctors and other healthcare providers often have a financial interest in running up the meter. As well, of course, doctors have strong incentives to play it safe amid rampant malpractice suits.
The Choosing Wisely program is intended to provide for better allocation of finite health care resources by engaging both doctors and patients in deciding what tests and treatments are appropriate, drawing upon evidence-based medicine. The program states that “recommendations should not be used to establish coverage decisions or exclusions.”
Instead the program recognizes that each patient is unique. Physicians and patients should use the guidelines, “Things Providers and Patients Should Question,” to discuss appropriate treatment plans. As part of its outreach effort the program has enlisted the trusted organization Consumer Reports to help disseminate information. The Choosing Wisely program has been doing its work since 2012. Since then 60 medical societies have developed lists of overused tests and procedures.
This year, seven grant recipients will be awarded funds to concentrate for close to three years on one issue that needs to be addressed, prescribing antibiotics for viral infections, along with at least two other overused tests or procedures on the lists. Applications are due by March 20, 2015.
“In order to achieve a national Culture of Health, it is important that we ensure physicians and patients have conversations about what tests and procedures are truly needed and address the challenge of overuse within our health care system,” said Susan Mende, BSN, MPH, senior program officer at RWJF.
With assets of close to $9 billion, RWJF is the nation’s biggest philanthropy dedicated solely to health. It’s the largest provider of healthcare grants in the United States, giving more than $400 million a year. RWJF’s mission “enables all in our diverse society to lead healthier lives, now and for generations to come. Throughout our work, we focus on creating equal opportunity to pursue the best health possible.”