In many areas of medicine, doctors could reduce the amount of health care they give patients without any adverse effects on the patients’ health. That’s the takeaway from a new campaign led by hospitals and the American Board of Internal Medicine Foundation to get specialists in various medical fields to eliminate wasteful or unnecessary procedures. Via the WSJ, a new study published in the Journal of American Medicine looks at one attempt to reduce cardiac monitoring (telemetry) among patients outside intensive care:
After the changes, the researchers found the hospital group’s mean daily number of non-ICU patients monitored with telemetry fell by 70%, from 357.5 to 109.1, while the mean daily cost for delivering non-ICU telemetry also fell by 70%, from $18,971 to $5,772. The changes had no negative effect on patient care; mortality rates at the hospitals remained stable, as did the number of “code blue” emergency calls to resuscitate patients.“It is remarkable to achieve such a substantial reduction in the use of this resource without significantly increased adverse outcomes,” Nader Najafi, assistant clinical professor at University of California, San Francisco’s Division of Hospital Medicine, wrote in an editorial accompanying the research publication.
It’s likely that there are pockets of unnecessary care like this all throughout the health system, as doctors themselves have often reported. Some would like to solve this problem by empowering centralized government bureaucracies equipped with standard operating procedures and data charts to impose uniform care throughout the system, but that approach poses as many problems as it purports to solve. Medical bodies like the AMA, however, surely have a role to play, and the key will be getting patients to act, when possible, more like informed consumers, equipped with enough information and incentives to choose doctors committed to providing only the care that is necessary.