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Choosing Wisely


awareness grows


Results from a May 2014 ABIM Foundation survey of 600 physicians nationwide show:


1 in 5 physicians say they


are aware of Choosing Wisely.


62% of those say they are


more likely to have reduced the number of times they recommend- ed a test or procedure, compared with 45 per- cent of those who are unaware of the effort.


2/3 of physicians acknowl-


edge responsibility to make sure their patients avoid unnecessary tests and procedures.


60% of physicians say they


are in the best position to address the problem.


more than 60 national specialty soci- eties have joined Choosing Wisely to identify and develop evidence-based recommendations for the top five tests and procedures they say are overused and have not always demonstrated benefits to patients. With the grant, TMA mobilized a consortium of county and specialty medical societies across the state to call attention to what now add up to more than 300 recommenda- tions. TMA’s online Choosing Wisely resource center at www.texmed.org/ choosingwisely has a suite of tools to help physicians understand and im- plement relevant recommendations at the practice level. (See “Start Choosing Wisely,” page 54.) Meanwhile, TMA partnerships


have helped Choosing Wisely gain traction at the state level with adop- tion by the state Medicaid program and the Texas Institute of Health Care Quality and Efficiency, established to implement Texas’ own version of health reform. Although the grant is coming to an


end, the work continues as physicians exercise what TMA Foundation Advi- sory Council member Nick Shroff, MD, describes as a less wasteful approach to improving the quality and efficiency of health care. “This is about deliver- ing the right care at the right time to enhance the quality of care, and it’s an ongoing partnership between the phy- sician and the patient.” His accountable care organiza-


tion (ACO), Integrated ACO, strives to provide the right care at the right time by sharing the specialty societies’ recommendations with the roughly 30 practices across the state that make up the organization. The physicians, care coordinators, and care teams, in turn, discuss the information with their patients, encouraging them to review patient-friendly Choosing Wisely re-


+ 52 TEXAS MEDICINE March 2015


sources accessible via the ACO’s web- site, www.integrated-aco.com. Dr. Shroff, a Plano urologist, says


the initiative aligns with his ACO’s goal of patient-centered, account- able care because it “centers care on patients’ individual needs, and that’s how we improve outcomes.” As more physicians and health


care organizations adopt Choosing Wisely, the campaign is contributing to what ABIM Foundation Executive Vice President and Chief Operating Officer Daniel B. Wolfson describes as an overall shift in the culture of health care. “We are increasing awareness, and we are changing attitudes toward overuse. That has been the first order of business, and TMA has been an in- credible leader.”


TMA TAKES ACTION Thanks to TMA’s and other grantees’ efforts, the campaign, now in its third year, is off to a good start. (See “Choos- ing Wisely Awareness Grows,” at left.) “We already have physicians moti-


vated to move in the right direction,” Temple nephrologist and past ABIM Foundation Chair Donald E. Wesson, MD, told a roomful of physicians at TMA’s Fall Conference in September. With the largest and most active


physician medical association in the country, Texas is positioned to be a “vanguard state” for advancing the program and a strong partner moving forward, he added. “Physician lead- ership is key to improving the qual- ity of health outcomes. I commend TMA for taking leadership in doing this because physician awareness [of Choosing Wisely] is key to making this happen.” TMA’s involvement in Choosing


Wisely began with the Council on Health Care Quality’s endorsement of the initiative in 2012 as yet another vehicle to prepare physicians for up-


For more on Choosing Wisely: www.choosingwisely.org.


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