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Q: What about Won't that decrease costs?

"What about Won't that decrease costs?" This question was posed by an informed commentor on a health website I frequent.

I think the Choosing Wisely campaign is pretty genius. It provides clinicians with helpful guidelines on how to manage the almost infinite amount of medical knowledge that is out there. It suggests ideas on how to order labs, scans, referrals, etc. Best of all, their intentions seem pretty pure.

My issue with the campaign, however, is that it doesn't actively address the cost of practicing medicine. Despite their suggestions, the costs of labs, medicines, and imaging won't be going down, no matter how good a steward of the public's money we are. Trust me, I do my very best to track down labs, interpret them in context, and save my patients – and subsequently us –money by not repeating them if necessary. I do my best to use my residency training to give my "best professional guess" and practice watchful waiting.

But the system doesn't support providers like me. The system says that you check, recheck, and check again, lest you be sued or you miss something. The system says that if you didn't get the labs in-house, how can you trust the results? The system says that if you have to sift through 50 pages of gobbledygook to find tthe results of one lab, just repeat it, and charge the insurance company (who then passes that cost on to the rest of us).

So Choosing Wisely is helpful, and I think does a great job of educating providers (especially post-residency) and patients. But it doesn't actively attack the causes of health care costs, inflation, greed, etc. P.S.Y.C.H. tackles this and more. I'm confident that Choosing Wisely and P.S.Y.C.H. could peacefully coincide during our health care renaissance.

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