A study in JAMA Internal Medicine found that, for seven treatment and testing services listed by the Choosing Wisely campaign as usually unnecessary, use of only two had declined, but use of the other five either didn’t change or increased.
A possible caveat: All the investigators in the study are affiliated with Anthem, the big health insurer, and led by Alan Rosenberg, M.D., the firm’s vice president for clinical pharmacy and medical policy .
The researchers recommended new measures to achieve substantial change in physician knowledge and behavior.
Many, though not all, of the services covered by Choosing Wisely are related to diagnostic imaging.
The study said: “The relatively small use changes suggest that additional interventions are necessary for wider implementation of Choosing Wisely recommendations in general practice. Some of the additional interventions needed include data feedback, physician communication training, systems interventions (e.g., clinical decision support in electronic medical records), clinician scorecards, patient-focused strategies, and financial incentives.”
