Top 5 ED Procedures to Avoid

Cheryl Clark, for HealthLeaders Media , February 18, 2014

In an accompanying editorial, JAMA Internal Medicine editors Deborah Grady, MD, and Rita Redberg, MD of University of California San Francisco and William Mallon, MD, of the University of Southern California, said they decided to publish the Partners' article because they see it as a "response" to the American Board of Internal Medicine Foundation's Choosing Wisely campaign's top five lists cultivated by more than 50 specialty societies.

"Although many professional societies have published 'top-five' lists, most have not detailed the methods by which the list was created. In some cases, it is clear that the lists were developed without much input from frontline practitioners, using a process that was not transparent ad without clear criteria for inclusion on the list," they wrote.

They noted that the American College of Emergency Physicians initially voted to not contribute a top 5 list for Choosing Wisely out of concern that emergency room patients are different because they are often sicker than patients of other specialty groups, because their care is often controlled by other specialists, and because in the ED, malpractice is perceived as a bigger threat. In the end, ACEP changed its mind and developed its own Choosing Wisely list.

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