Clinical Decisions Made in Primary Care Clinics Before and After Choosing Wisely

J Am Board Fam Med. 2015 Jul-Aug;28(4):471-4. doi: 10.3122/jabfm.2015.05.140332.

Abstract

Background: The Choosing Wisely campaign encourages physicians to avoid low-value care. Although widely lauded, no study has examined its impact on clinical decisions made in primary care settings.

Methods: We compared clinical decisions made for 5 Choosing Wisely recommendations over two 6-month time periods before and after the campaign launch and an educational intervention to promote it at 3 primary care residency clinics.

Results: The rate of recommendations adherence was high (93.2%) at baseline but did significantly increase to 96.5% after the launch. These findings suggest primary care physicians respond to training and publicity in low-value care, though further research is needed.

Conclusion: Given that even small decreases of physician test ordering can produce large cost savings, the Choosing Wisely project may help achieve the health care triple aim.

Keywords: Cost Control; Decision Making.

Publication types

  • Evaluation Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Clinical Decision-Making / methods*
  • Cost Control
  • Decision Support Systems, Clinical*
  • Guideline Adherence / economics
  • Guideline Adherence / statistics & numerical data*
  • Humans
  • Practice Guidelines as Topic
  • Practice Patterns, Physicians' / economics
  • Practice Patterns, Physicians' / statistics & numerical data*
  • Primary Health Care / economics
  • Primary Health Care / methods
  • Primary Health Care / standards*
  • Primary Health Care / statistics & numerical data
  • Program Evaluation
  • Quality Improvement / economics
  • Quality Improvement / organization & administration*
  • Quality Improvement / statistics & numerical data
  • United States
  • Unnecessary Procedures / economics
  • Unnecessary Procedures / statistics & numerical data*