"Choosing wisely" in an academic department of medicine

Am J Med Qual. 2015 Nov-Dec;30(6):566-70. doi: 10.1177/1062860614540982. Epub 2014 Jun 26.

Abstract

The "Choosing Wisely" campaign seeks to reduce unnecessary care in the United States through self-published recommendations by professional societies. The research team sought to identify factors related to low-value care in the Department of Medicine at the University of California San Francisco, using a subset of clinical scenarios published by the American College of Physicians. The team further explored respondents' values on cost consciousness. A notable minority disagreed with the identified low-value tests. In 6 of 8 scenarios, faculty were more likely to rate the scenarios as representing low-value testing (P < .05). Level of training was the only predictor of attitudes toward unnecessary care after linear regression analysis (coefficient 3.14, P < .001). Increased postgraduate education about cost of care is recommended.

Keywords: academic medicine; cost consciousness; cost control; low-value care; medical expenditures.

MeSH terms

  • Attitude of Health Personnel*
  • Faculty, Medical / psychology*
  • Hospital Costs
  • Humans
  • Internship and Residency*
  • Medical Overuse / prevention & control*
  • Practice Patterns, Physicians'
  • United States