Residents discuss determining the “one best test”

Recently AMA Wire http://www.ama-assn.org * noted: “An estimated one-third of health care costs—about $750 billion—don’t actually improve health, according to the Institute of Medicine (IOM). Residents’ exams often ask them to choose the “one best test” for diagnosis to avoid health care waste, but what if the real-world choice is “all of the above”?
“Trainees watch role models take a ‘do-everything-at-once’ approach, often just because they can… Often we are too far removed from the actual money exchanging hands to see the necessity of practicing cost-effective medicine.”
“According to Choosing Wisely, reasons residents and other physicians may over-order tests include: Concerns about medical liability, Just to be safe, Securing additional information as reassurance, Patients insist on specific testing, Keeping patients happy, Not enough time with patients, Fee-for-service system, New technology in practice.”
“Residents also have pointed to such reasons as duplicating behavior they have seen role modeled, a lack of knowledge of the costs and harms, or limited training in weighing the benefits relative to the costs and potential patient harms.”
* to read the full AMA Wire article “Residents discuss determining the “one best test” “, highlight and click on open hyperlink
http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/residents-discuss-determining-one-test
Doctor, Did You Wash Your Hands? ™ provides information to consumers on understanding, managing and navigating health care options.
Jonathan M. Metsch, Dr.P.H., is Clinical Professor, Preventive Medicine, Icahn School of Medicine at Mount Sinai; and Adjunct Professor, Baruch College ( C.U.N.Y.), Rutgers School of Public Health, and Rutgers School of Public Affairs and Administration
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