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Choosing Wisely addresses overtreatment

In a recent New Yorker article, Atul Gawande explores the ongoing crisis of unnecessary care in the United States, discussing the issues with doctors, patients and those who study the issue from coast to coast.

What it all comes down to is this: the United States health care system is facing an epidemic of overdiagnosis, overtreatment and ineffective care that directly impacts quality and cost. Addressing these challenges requires the cooperation of all who participate.

In our own backyard, sometimes people may be getting too much care, too. For example, in our 2014 report, Different Regions, Different Health Care: Where You Live Matters, we found:

  • Women aged 35–44 living in Puyallup were 193% more likely to have a hysterectomy compared to women of the same age living in Seattle.
  • People living in Everett were more likely to receive a CT scan than the rest of the Puget Sound region.

This care may not always be necessary, and the impact of this extra care can mean greater cost and greater medical risk – not to mention the emotional burden that unnecessary treatment causes.

Providing the data that highlights this problem and bringing together all the stakeholders to address it is what we’re all about. In fact, efforts to change the culture of overuse are already underway in our state, and the Alliance is as the forefront of this work. With the Choosing Wisely initiative, we’re working with the Washington State Medical Association, Washington State Hospital Association and leading providers to find systematic ways to correct the problem, by sharing information about our state’s performance and sharing guidelines for when care is appropriate for certain common tests or procedures.

This initiative seeks to help physicians and patients have conversations about the potential overuse of tests and procedures and supports physician efforts to help patients make smart and effective care choices. Physicians and patients need to work together to choose care supported by evidence, that doesn’t duplicate other tests or procedures, that won’t cause harm and is truly necessary. These “Things Physicians and Patients Should Question” lists provide specific, evidence-based recommendations physicians and patients should discuss to help make wise decisions about the most appropriate care for them.

Published: May 21, 2015

About Washington Health Alliance

The Washington Health Alliance is a place where stakeholders work collaboratively to transform Washington state’s health care system for the better. The Alliance brings together organizations that share a commitment to drive change in our health care system by offering a forum for critical conversation and aligned efforts by stakeholders: purchasers, providers, health plans, consumers and other health care partners. The Alliance believes strongly in transparency and offers trusted and credible reporting of progress on measures of health care quality and value. The Alliance is a nonpartisan 501(c)(3) nonprofit with more than 185 member organizations. A cornerstone of the Alliance's work is the Community Checkup, a report to the public comparing the performance of medical groups, hospitals and health plans and offering a community-level view on important measures of health care quality (www.wacommunitycheckup.org).

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