Although the majority of physicians say they are comfortable telling patients why certain tests and procedures are not worth the cost or could be avoided, they feel these discussions are increasingly difficult to have, according to a survey published in Health Affairs.
In 2014, 42 percent of physicians said conversations with patients about avoiding low-value care have become more difficult in recent years, compared to 46 percent in 2017. The results also showed the majority of physicians who are comfortable having these discussions is shrinking slightly. In 2014, 82 percent of physicians said they were "very comfortable" discussing avoidable, low-value care with patients, compared to 74 percent in 2017.
The survey was conducted to gauge the effectiveness of the American Board of Internal Medicine's Choosing Wisely campaign, an initiative launched five years ago to help physicians better identify and avoid services that provide little benefit for the cost. Researchers found awareness of the campaign barely increased (21 percent in 2014 versus 25 percent in 2017). And while the majority of physicians who were aware of the campaign said it was helpful, the survey's findings suggest it may have not been effective in raising awareness.
Physicians indicated fears of malpractice, the desire to meet patient demand and satisfaction, and concern about missing an underlying, serious diagnosis were the main factors contributing to continued use of low-value tests and procedures. Most physicians said malpractice reform and the availability of more evidence-based information about unnecessary care would help reduce the use of avoidable tests and procedures.
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