540.741.1557
Mary Washington Health Alliance
  • Provider Login
  • Find a Doctor
Search
  • Home
    • About Us
      • Provider Directory
        • New Providers
          • Locations
            • Contact
              • Board of Managers
              • Alliance Facts
              • Alliance Staff
              • Medical Imaging at Lee's Hill
              • Medical Imaging of North Stafford
              • Imaging Center for Women
              • Mary Washington Hospital
              • Stafford Hospital
              • Emergency & Outpatient Center - Lee's Hill
              • Fredericksburg Ambulatory Surgery Center
              • Medical Arts Pharmacy
              Search Close
              • Call Today Call Today
              • Email Us
              • Our Map
              • Menu
                Home
                About Us
                Provider Directory
                New Providers
                Locations
                Contact
                News
                Provider Education
                Provider Login
                MW Newsletter
                ADA Notice
                Privacy Policy
                Site Map
              News 2018 July Message from the Medical Director

              Message from the Medical Director

              LIFE IS A SERIES OF CHOICES

              On a number of occasions, my wife has reminded me that “life is a series of choices’ (especially after I’ve made, what she considered, the “wrong choice”).

              Similarly, the practice of medicine can be viewed as a series of choices.

              For example:

              • Should I prescribe an antibiotic for this patient’s acute bronchitis?
              • Should I order an MRI for this patient’s low back pain?
              • Should I continue treating this condition myself or refer to a specialist?
              • Should I continue to observe and monitor or is it time to operate?
              • Should I discharge my patient today or keep him/her in the hospital another day?

              As it turns out, many of the treatment choices we make may be considered of no or low value to the patient. Several studies have shown that, on average, about 30% of such treatment decisions fall into this no/low value category. A survey commissioned by the American Board of Internal Medicine (ABIM) in 2014 included the following findings:

              Nearly ¾ of U.S. physicians say that the frequency with which doctors order unnecessary medical tests and procedures is a serious problem for America’s health care system

              72% of physicians say that the average medical doctor prescribes an unnecessary

              test or procedure at least once a week.

              53% of physicians say that even if they know a medical test is unnecessary, they order it if a patient insists.

              To help address these concerns, the ABIM launched the “Choosing Wisely®” campaign in 2012 which is designed to promote conversations between clinicians and patients by helping patients choose care that is:

              • Supported by evidence
              • Not duplicative of other tests or procedures already received
              • Free from harm
              • Truly necessary

              Medical specialty societies were called upon to identify tests or procedures commonly used in their fields whose necessity should be questioned and discussed with patients. To date, over 70 medical specialty societies have published more than 500 recommendations of overused tests and treatments. These are accessible through the Choosing Wisely website (www.choosingwisely.org) where you can also download the Choosing Widely app to your iPhone/iPad or Android device. Some examples include:

              • (from Anesthesiology) Don’t obtain baseline laboratory studies in patients without significant systemic disease (ASA I or II) undergoing low-risk surgery – specifically, CBC, BMP or CMP, coagulation studies when blood loss (or fluid shifts) is/are expected to be minimal
              • (from Pulmonology) For patients recently discharged on supplemental home oxygen following hospitalization for an acute illness, do not renew the prescription without assessing the patient for ongoing hypoxemia.
              • (from Dermatology) Don’t prescribe antifungal therapy for suspected nail fungus without confirmation of a fungal infection. Approximately half of all patients with suspected nail fungus do not have a fungal infection.
              • (from Cardiology) Don’t perform stress cardiac imaging or advanced non-invasive imaging as a pre-operative assessment in patients scheduled to undergo low-risk non-cardiac surgery.
              • (from Gastroenterology) For a patient with functional abdominal pain syndrome (as per ROME IV criteria) CT scans should not be repeated unless there is a major change in clinical findings or symptoms.

              I invite you to visit the Choosing Wisely website and review the recommendations pertinent to your specialty. You may or may not agree with all of them though keep in mind that these are recommendations promoted by the pertinent specialty society. And, of course, guidelines and recommendations are just that – “guidelines” to help “guide” your clinical decisions, not supplant your clinical judgement.

              Avoiding unnecessary medical tests, treatments and procedures is good medicine and, as such, should be part of the Alliance’s mission to enhance the health of our population.

              Categories: MWMD Newsletter


              Previous Post  |  Next Post

              Recent Posts

              • ACC-Choosing Wiely
              • ACC-Choosing Wiely
              • Message from the Chairman of the MWMD Board
              • Message from the Medical Director-Update on Testing for COVID-19
              • Committee Corner-Message from Communications & Education Chair
              • Welcome New Providers
              • Provider/Practice Updates
              • NextGen ACO Model Extended

              Categories

              • Blog (12)
              • Featured (3)
              • MWMD Newsletter (98)
              • News (35)

              Archives

              • 2020 (15)
              • December (2)
              • July (6)
              • April (7)
              • 2019 (27)
              • October (10)
              • July (8)
              • January (9)
              • 2018 (47)
              • October (13)
              • September (4)
              • July (12)
              • March (12)
              • January (6)
              • 2017 (33)
              • December (5)
              • November (2)
              • October (4)
              • September (7)
              • August (11)
              • May (2)
              • April (2)
              • 2015 (10)
              • December (1)
              • November (2)
              • September (1)
              • July (1)
              • June (1)
              • May (1)
              • April (1)
              • March (1)
              • January (1)
              • 2014 (4)
              • October (1)
              • September (2)
              • January (1)
              Mary Washington Health Alliance

              Mary Washington Health Alliance
              2300 Fall Hill Avenue, Suite 308
              Fredericksburg, VA 22401
              View Map [+]
              540.741.1557 http://www.mwhealthalliance.com/

              Site Links

              • About MWMD
              • Our Doctors
              • Our Hospitals and Facilities
              • Board of Managers
              • MW Health Alliance ACO
              • MWMD Annual Value Report
              • MWMD Newsletters
              • News
              • Community Health Record
              • Contact Us
              • Provider Education
              • Site Map
              • Notice of Non-Discrimination
              • ADA Notice
              • Health Link Nurse Line

              Hospitals and Facilities

              • Mary Washington Hospital
              • Stafford Hospital
              • MWH Emergency Department at Lee's Hill
              • Fredericksburg Ambulatory Surgery Center
              • MWHC Medical Arts Pharmacy

              Imaging Centers

              • Medical Imaging of Fredericksburg
              • Medical Imaging of Lee’s Hill
              • Medical Imaging of North Stafford
              • Imaging Center for Women
              Powered by Scorpion Healthcare