Monday, 16 April 2012

Choosing Wisely, Experience Required

Choosingwisely - An Initiative of the ABIM Foundation

This is a really good initiative by the American Board of Internal medicine - it promotes shared care decision making for diagnostic procedures and treatments, and, it also encourages doctors to stop and think before they request investigations - i.e. the evidence for a particular imaging procedure etc.
It used to be the case that the excessive requesting of investigations due to a relative ease of supply was an American phenomenon. The transformation in the provision of imaging services that has occurred in the National Health Service in the UK over the past decade as a result of massive investment has had the same effect over here. Ordering needless investigations, be they for imaging or for blood tests, is not just wasteful but  is potentially harmful if it means clinical assessment is being replaced by yet another easily available XRay or CT.  One way of reversing this worrying trend is to ensure the presence of an experienced pair of hands on the frontline  - we're back to 7 day consultant working again!!