‘Choosing Wisely’ Guides Our Conversations and Decisions

‘Choosing Wisely’ Guides Our Conversations and Decisions

Eric Barbanel, MD

Primary Care and Internal Medicine, New York

Choosing Wisely has a presence in our office, helping to guide our conversations and decisions. When I walk into an exam room and see a patient reading one of the Consumer Reports “5 Questions” posters, it opens the door for an easy conversation about Choosing Wisely and the overall concept of overuse. It also lets my patients know that it’s OK for them to ask the questions that they may feel uncomfortable asking, particularly about the need for and expense of certain tests or treatments.

I’ve had plenty of patients who have been told or assumed that they needed a repeat colonoscopy after three to five years, not knowing that the evidence shows that, for most people, they only need them every 10 years. When I’m having conversations about this issue with my patients, it’s easy to pull out the Choosing Wisely brochure from Consumer Reports on colonoscopies to show them when they’re needed, when they’re not, and the potential risks. Similarly I can do the same thing for conversations around back pain, colds, and testosterone use and other issues.

Having the Consumer Reports name on the Choosing Wisely materials gives a third-party validation. It’s not just something that I’m saying, it’s not something my practice is saying, and it’s not something that the insurance company or the government is dictating, but rather it’s what Consumer Reports is saying. This helps to limit patients’ concerns about potential conflicts of interest.

We put a lot of the Choosing Wisely brochures from Consumer Reports into nice little binders placed throughout our waiting rooms, with stickers on them to let people know not to take them and that they were property of our practice. We also have signs indicating that the binders should be returned to our front desk. The funny thing is that patients liked them so much that they took the binders home with them! It showed me that people definitely are looking for the type of information that Choosing Wisely and Consumer Reports are providing.

Another way that we’re trying to share Choosing Wisely information is through the microsite that we built with Consumer Reports. All of the Choosing Wisely handouts are organized there by physician guideline and specialty, like cardiology, dermatology, geriatrics, and ob/gyn. My hope is that we can modify our workflow so that, when the patient is being brought to the exam room, we can pull the appropriate Choosing Wisely handout from our microsite and give it to the patient right then.

Having the Choosing Wisely posters in our exam rooms and easy access to the brochures equally helps my patients and me. It seems that once I have the Choosing Wisely conversation with my patients, more than 99 percent of them have a better understanding about the risks associated with overuse of medical tests and treatments. That leads us to be able to make a more informed decision about their care together.

Consumer Reports has no financial relationship with this healthcare provider and does not endorse products or services.