April 20, 2012 OHA Director's messages on the web
To: All OHA employees
From: Bruce Goldberg, M.D., Director

Choosing Wisely – Help in making health care decisions

"The well-timed question is more impacting than an answer."
~ Mary Anne Radmacher

One of the most fundamental truths of health care is that having numerous medical procedures – more tests, more hospitalizations – does not always mean having better health. Yet, unnecessary testing is an easy trap to fall into, especially when patients don't have good information about the effectiveness and risk of procedures. In fact, unnecessary testing is one of the major reasons that health care costs about 30 percent more than it should.

Reducing this waste is central to the work we are doing at the Oregon Health Authority.

When Coordinated Care Organizations begin serving Oregon Health Plan clients, they will be accountable for ensuring that patients do not have to undergo unnecessary tests that don't contribute to better health. The Public Employees' Benefit Board also has taken on an increased role in education, so we can make smarter decisions about our health care.

These efforts will be helped by a growing national understanding of the true costs of many of these tests. Recently, nine physician groups joined forces with Consumer Reports, AARP, SEIU, Wikipedia and others to educate us all about the high costs and risks of frequently used but unnecessary medical tests.

This is a significant step forward in our move to improve the quality of health care and reduce wasteful spending.

The Choosing Wisely campaign has released a list of "Five Things Physicians and Patients Should Question." On the website, health care consumers and providers can find specific, evidence-based recommendations to help them make wise decisions about the most appropriate care based on their individual situations.

The guidelines offer information about tests and treatments such as:

  • If we have a fainting spell, should we get an MRI? According to the American College of Physicians, probably not. Research has shown that, with no evidence of seizure or other neurologic symptoms during an exam, patient outcomes are not improved with brain imaging studies.
  • Do we need stress imaging tests during our annual checkups? The American College of Cardiology says these tests are unnecessary for otherwise healthy adults without cardiac symptoms
  • If we have chronic sinusitis, should we get a CT scan or antibiotics? The American Academy of Allergy, Asthma & Immunology says that might not be the right way to go.

The fact sheets available on the Choosing Wisely website are easy to understand and helpful tools for any of us making health care decisions.

When we receive the right care at the right time in the right way, it helps us all be healthier and creates a more affordable and patient-centered health care system. That truly is the wise choice.

OHA on the web