Berwick: Zapping Overtreatment, Costs Takes 'Courage'

Cheryl Clark, for HealthLeaders Media , August 1, 2013

The Lown Institute Tackles "Inculturation"

President Vikas Saini, MD, tells me the institute is tackling the problem from another angle, that of the habits and "inculturation," engrained in physicians to influence their overtreatment of patients starting in medical school.  

It's also focusing on the institutional barriers, such as poor bench-to-bedside translation of evidence, gaps in physician knowledge, defensive medicine practices, and patient misunderstandings that result in treatment trajectories the patient never would have wanted.

"The real issue is conflict of interest," Saini says. "What it means to be a healthcare professional is that you take your special knowledge and skill and put it at the service of the patient." But conflicts of interest "have proliferated, and not just with industry support, but much more broadly.

"There's so much money in the system and the money seems to have taken over." An institute survey on physician and hospital overuse is in the planning stages.

AHA to Address 'Appropriateness'

Though Umbdenstock was excited enough about the AHA project to tell Berwick about it, the AHA is "not ready to share details at this time," a spokeswoman wrote me in an e-mail.  

So I was left to ask others what a "Choosing Wisely-" like campaign aimed at reducing "excess," "overtreatment," or "inappropriate" services within acute care institutions might look like.

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