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Published on: August 1, 2019
Clinical Decisions Made in Primary Care Clinics Before and After Choosing Wisely
Amanda Kost1, Inginia Genao2, Jay W Lee2
1From the Department of Family Medicine, University of Washington, Seattle (AK); Department of Internal Medicine, Yale University School of Medicine, New Haven, CT (IG); Long Beach Memorial Family Medicine Residency, Long Beach, CA (JWL); and the Department of Family Medicine, Warren Alpert Medical School, Brown University, Providence, RI (SRS). akost@uw.edu.
Background:
The Choosing Wisely campaign encourages physicians to avoid low-value care. Although widely lauded, no study has examined its impact on clinical decisions made in primary care settings.
Methods:
We compared clinical decisions made for 5 Choosing Wisely recommendations over two 6-month time periods before and after the campaign launch and an educational intervention to promote it at 3 primary care residency clinics.
Results:
The rate of recommendations adherence was high (93.2%) at baseline but did significantly increase to 96.5% after the launch. These findings suggest primary care physicians respond to training and publicity in low-value care, though further research is needed.
Conclusion:
Given that even small decreases of physician test ordering can produce large cost savings, the Choosing Wisely project may help achieve the health care triple aim.
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