Pediatrician Suggests You Choose Wisely With Patients

Marylou Buyse, MD, pediatrician and chief medical director of Scott & White Memorial Hospital Health Plan, wants Texas physicians to spark discussion with patients by using Choosing Wisely. 

"This is particularly exciting to Scott & White," Dr. Buyse said. "An initiative like Choosing Wisely has been missing for a long time in specialty care."

Choosing Wisely promotes conversations between physicians and patients based on evidence provided by dozens of national specialty societies. These organizations representing medical specialists were asked to "choose wisely" by identifying tests or procedures commonly used in their field whose necessity physicians and patients should question and discuss. The resulting lists of "Five Things Physicians and Patients Should Question" will aid conversations about many frequently ordered tests or treatments.

Dr. Buyse calls the program a "terrific initiative, a really fresh new view on patient and doctor conversation."  

Scott & White Health Plan recognizes the importance of conversations between patients and physicians. Dr. Buyse explained that when specialty societies signed onto the Choosing Wisely initiative, each one provided a list of recommendations that was supported by their evidence.

"Physicians should be practicing and promoting evidence-based medicine," Dr. Buyse said. "Choosing Wisely gives that to specialty care in a broad way by providing lists," making it easier for physicians and healthier for patients. 

Scott & White Health Plan and Choosing Wisely urge physicians and patients to talk about the recommendations to find what is best for the patient's care, she says. 

"Evidence, patients, and physicians. This triangle is linked in the campaign and is the heart of the campaign," Dr. Buyse said.

Dr. Buyse explained how simplicity makes Choosing Wisely an attainable goal. Information overload leads to errors in health care. But the Choosing Wisely lists help physicians manage the information they share with their patients. She says it takes four times as long without the written lists to explain to patients why a particular choice was made.

"It is an easy way to coordinate care," Dr. Buyse said. "I would advise getting information for patients in the office to remind you. Get information for the conversation. Both physician and patients have a stake in care."

Dr. Buyse has promoted the Choosing Wisely initiative since early 2012. Scott & White Health Plan provides six Choosing Wisely lists that patients need most. Their goal is to try to "close the loop" for primary care by using patient-physician conversations.

The ABIM Foundation awarded TMA and its philanthropic arm, the TMA Foundation, a grant to advance the Choosing Wisely campaign among Texas physicians. Nine Texas county medical societies, six state medical specialty societies, and the Texas Osteopathic Medical Association are participating in the program with TMA. Support for the grant program comes from the Robert Wood Johnson Foundation.   


Action, Dec. 4, 2013


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