In 2009, NPA was funded to identify five steps primary care physicians could take in their daily practices to achieve the highest goals of doctors and patients alike: excellent care that we can afford together. In early 2011, an article was published that focused on the issue of good stewardship in clinical practice. This article looked at 5 high-cost, low-value medical interventions in each of internal medicine, family medicine, and pediatrics and called on physicians to be good stewards of medical resources by avoiding expensive, unnecessary care.
This initiative was later developed into the “Choosing Wisely” campaign in which 9 medical specialty organizations developed lists of Five Things Physicians and Patients Should Question.
Each of these projects encourages physicians to be good stewards of our medical resources: to practice evidence-based medicine, to provide necessary care when appropriate, and to avoid providing excess or unnecessary care both to protect patients (as medical care is a major source of mortality in the US–PDF) and to reduce unnecessary costs.
Now, there is a new reason for physicians to be good stewards of our medical resources: employers are looking to reduce their healthcare costs, which are increasing in an unsustainable manner. In a recent commentary, Helen Darling (President of the National Business Group on Health) notes the importance of gaining control of our national healthcare costs and highlights “Choosing Wisely” as a promising initiative.
NPA’s main interest in promoting good stewardship in medicine is to ensure patients and physicians understand how best to provide necessary medical care in a cost-effective manner. However, this interest aligns with a national need to address healthcare cost increases that threaten businesses as well as our public health insurance programs.
We are proud to have been there at the beginning, and we will continue to work on this critical issue.