Campaign Aims to Cut Unnecessary Medical Spending

The American Board of Internal Medicine (ABIM) Foundation and nine other leading medical specialty societies have launched the Choosing Wisely campaign in an effort to decrease unnecessary health care spending and improve the quality of care patients receive.

The idea for the initiative came from the National Physicians Alliance, which piloted a similar project in 2009. Its goal is to encourage discussion within the medical community regarding health care costs and to better inform physicians and patients about limited health care resources, Christine K. Cassel, MD, president and CEO of the ABIM Foundation, said in a press release.

Groups participating in the initiative will develop a list of questionable tests and procedures.

“Physicians play a leading role in addressing problems with our nation’s health care system,” Cassel said. “That is why the ABIM Foundation is proud to be working with specialty societies that have proactively decided to address some of the most important issues in health care head on.”

US health care spending is expected to reach $4.6 trillion by 2020, when it will take up almost 20% of the nation's gross domestic product, according to the Centers for Medicare & Medicaid Services.

Virginia L. Hood, MBBS, president of the American College of Physicians, said that many factors contribute to the misuse of medical tests and procedures, which are major drivers of rising costs, such as a lack of guidelines for certain clinical issues. Physician habits and patient expectations also contribute to unnecessary spending.

By April, each organization involved with the initiative will compile a list of five possibly unnecessary tests and procedures that are costly, commonly used in their specialty, or both. Each choice must be supported by research and will be revised as new evidence arises.

The campaign expects to enlist more specialty organizations over time. "We're not done yet. This is just the first nine," Cassel said in the press release. "We're very interested in hearing from specialists who may want to participate."

Medical specialty organizations participating in the initiative include:

• American College of Physicians
• American Academy of Allergy, Asthma & Immunology
• American Academy of Family Physicians
• American College of Cardiology
• American College of Radiology
• American Gastroenterological Association
• American Society of Clinical Oncology
• American Society of Nephrology
• American Society of Nuclear Cardiology

The campaign has yet to decide how it will disseminate the information that it assembles.

"In this current health care environment, everyone is concerned about rising health care costs," Cassel told American Medical News. "It is a time for both physicians and patients to have better information at their fingertips."