VIDEO: Good Stewardship / Model conversations with patients about overtesting and overtreatment

The National Physician Alliance (NPA) has done a lot of work in the area of preventing overdiagnosis and empowering patients to find the right amount of care. They are a partner in the Tandem Health project/app, created Top 5 lists (in good stewardship) which served as a model for the Choosing Wisely Campaign, and promote responsible prescribing (by limiting influence of the pharmaceutical industru) through The Unbranded Doctor.

Created in 2011, this video is a timeless tool for Good Stewardship. It gives a simple, 5-step plan of how health care providers can discuss unnecessary tests and treatments with patients.

They suggest:

1. Clarify what the patient’s true concerns are
2. Provide the patient with the information he/she needs to understand the plan
3. Be courteous and respectful
4. Provide clear contingency plan
5. Make sure the patient is satisfied with the plan

Less is More: Inspiration from ABIM's Choosing Wisely Campaign; [video]

In medical school and residency, I was exposed to a "right care" approach by preceptors who championed Evidence-Based Medicine (EBM) and patient-centered care (PCC). This tended to be in rural, geriatric, and palliative care settings.

However, it wasn't until I heard about Choosing Wisely in the Hospitalist literature in late 2011 that I realized there were some formal education and policy efforts aiming to promote this approach to practice. Now, the American Board of Internal Medicine (ABIM)'s project, Choosing Wisely, has become a well-known entity.

No one likes being told "you are doing it wrong." But physicians do want to give the best care possible, empower patients, and learn about new developments. We enjoy being shown that  "you can do it better" and there's no better way to inspire us than framing this as an invitation to be professional.

I've certainly heard the call to action, and I hope you will too: