A lack of consensus guidelines or a belief that current evidence does not support such guidelines might be justified if a clinician expresses a commitment to patient-centered care and shared decision making.
AMA J Ethics. 2018;20(11):E1007-1016. doi:
10.1001/amajethics.2018.1007.
Corporatization in health care has complicated clinicians’ and organizations’ efforts to balance interests of individual patients against an organization’s bottom line.
AMA J Ethics. 2020;22(3):E187-192. doi:
10.1001/amajethics.2020.187.
Measuring outcomes alone is not the answer. There should be a way to reward the doctor for educating a patient about lifestyle modifications and then documenting that the care provided followed patient preferences.
Although not everything on the Choosing Wisely lists is likely to reduce low-value care, it is a good starting point for a conversation about curtailing low-value interventions.