What it takes to make wise healthcare choices

Despite calls for more cost-efficient care, "choosing wisely" isn't as easy as it sounds. While providers play a pivotal role in reducing unnecessary healthcare expenditures, they can't do it alone.

But with new additions to the "Choosing Wisely" campaign, providers are now armed with a list of 135 tests and treatments that are deemed overused or inappropriate. These recommendations won't guarantee high-value care, but they can motivate discussions about cost and quality of care issues.

Such discussions require behavioral changes from both providers and patients. To bring about those changes, panelists at an Institute of Medicine (IOM) workshop say the industry needs to incentivize doctors to allow patients to take a greater role in their care and embrace open dialogue.

Moreover, countless research and media reports have driven home the importance of patient-provider relationship and communication to lowering costs and improving care.

That means patients need to take a leading role in the cost-control movement and become active participants in their care. In fact, with increased patient activation, hospitals see lower costs and better outcomes.

But getting patients engaged and thinking about lower-cost treatment options isn't easy. A major barrier to cost-efficient efforts is that patients often equate cost with quality, not to mention their preference for what they perceive as the best care, regardless of expense, as FierceHealthcare reported last week.

That's why healthcare leaders must address barriers to shifting public opinion about healthcare costs, with effective public messages and delivery methods, David Rothman, professor of Social Medicine at Columbia University College of Physicians and Surgeons, wrote in a Health Affairs blog post earlier this month.

Rothman recommended allowing patients to examine data themselves. That would be a welcome move, as 90 percent of patients surveyed last fall said they wanted more information, not only their doctor's best recommendation, for making a medical decision.

Recognizing that patients need better information to make wise healthcare decisions, Consumer Reports is working with the American Board of Internal Medicine Foundation to develop and disseminate patient education materials to supplement the Choosing Wisely initiative.

However, providers and patients must "choose wisely when choosing wisely," internist Matthew Mintz pointed out in a blog post. "Based on the headlines, one might think that these tests or treatments should never be done. These are commonly overused tests and treatments, not useless," he noted.

So while routine use of certain procedures should warrant a patient-provider discussion, it's important both parties understand when they are medically necessary to really make a smart choice. - Alicia (@FierceHealth)