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PUBLIC HEALTH

Choosing Wisely An initiative of the American Board of Internal Medicine (ABIM) Foundation SCCMA-MCMS is publishing various Choosing Wisely® lists of "Things Physicians and Patients Should Question." Choosing Wisely - see page 17 - is an initiative of the ABIM Foundation to help physicians and patients engage in conversations to reduce overuse of tests and procedures, and support physician efforts to help patients make smart and effective care choices.

16 | THE BULLETIN | MARCH/APRIL 2014

Originally conceived and piloted by the National Physicians Alliance through a Putting the Charter into Practice grant, leading medical specialty societies along with Consumer Reports, have identified tests or procedures commonly used in their fields whose necessity should be questioned and discussed. The resulting lists of "Things Physicians and Patients Should Question" will spark discussion and the need - or lack thereof - for many frequently ordered tests or treatments.

HOW THIS LIST ON PAGE 17 WAS CREATED

The American Academy of Family Physicians (AAFP) list is an endorsement of the five recommendations for Family Medicine previously proposed by the National Physicians Alliance (NPA) and published in the Archives of Internal Medicine, as part of its Less is MoreTM series. The goal was to identify items common in primary care practice, strongly supported by the evidence and literature, that would lead to significant health benefits, reduce risks and harm, and reduce costs. A working group was assembled for each of the three primary care specialties; family medicine, pediatrics and internal medicine. The original list was developed using a modification of the nominal group process, with online voting. The literature was then searched to provide supporting evidence or refute the activities. The list was modified and a second round of field testing was conducted. The field testing with family physicians showed support for the final recommendations, the potential positive impact on quality and cost, and the ease with which the recommendations could be implemented. More detail on the study and methodology can be found in the Archives of Internal Medicine article: The “Top 5” Lists in Primary Care.

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