Prompting physicians to follow care guidelines can save millions

Prodding physicians to follow recommended care guidelines can help reduce utilization and reduce costs, the Wall Street Journal reported.

One group of hospitals in Delaware, Christiana Care Health System, prompted its physicians to follow the cardiac monitoring guidelines set forth by the American Heart Association, according to the WSJ. That move alone cut monitoring costs by 70 percent without any changes to the quality of care provided to patients. The savings: $4.8 million a year.

The push in Delaware is part of the "Choosing Wisely" campaign launched by the American Board of Internal Medicine Foundation. Choosing Wisely is intended to cut down on unnecessary testing and medical procedures, which contribute to as much as 20 percent of healthcare costs in the United States. However, the program has come under some criticism because physicians who helped choose the targeted procedures avoided some high-dollar surgeries such as spinal fusion.

Another "Choosing Wisely" campaign involving Johns Hopkins Bayview Medical Center in Baltimore helped reduce the usage of a type of blood test to detect whether patients have undergone a heart attack. The cutback in the use of that assay saved the hospital about $1 million a year, according to the Wall Street Journal.

Although some physicians have been resisting making such changes, many still believe it's not their job to worry about costs. That's despite the fact that about three-quarters of of doctors believe their colleagues regularly order unnecessary tests and procedures on at least a weekly basis.

Resistance initially occurred with the Johns Hopkins physicians, many of whom wanted extra evidence to change their mind, the Wall Street Journal reported. "I think it's becoming increasingly accepted," said Marc Larochelle, a doctor who pushed the blood test reduction, but he told the Journal that having doctors involved is key, "rather than having non-medical folks try to figure that out and push down from above changes that make less sense."

To learn more:
- read the Wall Street Journal article