practice partner
Why re-thinking
more is better
Campaign to help doctors engage in
conversations about unnecessary
tests paying off
BY STUART FOXMAN
photo: istockphoto.com
S
am and Paula present with abdominal pain. Their doctors take the
histories and do physical exams,
each ruling out the worst. Sam’s
doctor says not to worry but to follow
up if anything changes. The other doctor
discovers that Paula is terribly anxious and
insistent on an ultrasound, so relents.
Dr. Andrew Quinn gets it. As a family
physician in Tweed, he understands the
time pressures of the day. “It’s just easier
to get someone out the door. You can tell
from a brief interview or exam that nothing
serious is going on, but you don’t have 30
minutes to explain so you do a requisition
for the test.” It may seem harmless or expedient, but Dr. Quinn describes it another
way: “That’s just bad medicine.”
He was among the speakers at the inaugural national meeting of Choosing Wisely
Canada (www.choosingwiselycanada.org),
held recently in Toronto. Close to 300
people attended, including clinical leaders,
representatives of physician specialty societies, medical students and residents, and
patient representatives.
CWC is a campaign to help physicians
and patients engage in conversations about
unnecessary tests, treatments and proce-
dures. The goal is to make smart and effective choices to ensure high-quality care.
All provincial and territorial medical associations have endorsed the CWC campaign,
and in fact this College references the campaign in the new CPD section of our website
and in our newly designed peer assessment
handbooks. A range of Canadian national
specialty societies, representing a broad
spectrum of clinicians, are also participating.
They’ve developed lists of commonly-used
approaches that aren’t supported by evidence
and should be questioned.
The recent meeting shared how organizations and jurisdictions are implementing
and scaling CWC recommendations. As
CWC notes, unnecessary tests and treatments don’t add value to care. To the contrary; they detract from care by potentially
exposing patients to harm, leading to more
tests to investigate false positives and contributing to patient stress. Moreover, this all
strains the resources of the health system