Emergency Physician Knowledge, Attitudes, and Behavior Regarding ACEP's Choosing Wisely Recommendations: A Survey...

Area of Science:

• Emergency Medicine
• Health Services Research
• Medical Practice Management

Background:

• The Choosing Wisely campaign aims to reduce low-value healthcare services.
• The impact of Choosing Wisely on emergency physician behavior remains largely unquantified.
• Assessing emergency physicians' knowledge, attitudes, and behaviors regarding Choosing Wisely is crucial for effective implementation.

Purpose of the Study:

• To evaluate emergency physicians' awareness, attitudes, and self-reported behaviors related to the Choosing Wisely campaign.
• To identify the prevalence of specific low-value practices in emergency medicine.
• To understand the primary drivers behind the performance of low-value services by emergency physicians.

Main Methods:

• A cross-sectional survey was conducted among emergency physicians at a national meeting.
• A total of 765 physicians (93.4% response rate) completed the survey.
• Data collected included awareness of the campaign, attitudes towards low-value services, and self-reported behaviors and reasons for practice.

Main Results:

• A majority of physicians felt more comfortable discussing low-value services (64.5%) and reported reduced utilization (54.5%).
• Common low-value practices included CT brain for minor head injury (29.9%) and antibiotics for sinusitis (26.9%).
• Patient/family expectations were the main driver for antibiotic prescribing, while concern for serious diagnoses influenced advanced imaging decisions.

Conclusions:

• Familiarity with Choosing Wisely does not fully translate to reduced low-value services in emergency medicine.
• The reasons for performing low-value services vary, necessitating tailored strategies for different clinical scenarios.
• Enhanced dissemination and implementation efforts are required, potentially targeting specific drivers of low-value care.