Choose Wisely

Wednesday, April 18, 12 To The Editor of the Miami Herald RE: “Better health, fewer tests”, April 16th, 2012 As a board-certified family physician and addiction specialist I endorse the initiative, Choosing Wisely, of the ABIM Foundation supporting evidence-based recommendations that should be discussed to help make wise decisions about the most appropriate care based on a patients’ individual situation. We must understand that health care costs are finite! We reached a tipping point that leaves only two options: health care rationing, or the efficient utilization of treatment resources. This requires a new health care delivery paradigm based on expanded primary care access, care coordination, utilization of information technology to measure quality and outcome of care, and the involvement of the patient as a partner and not the object of care. Such a Patient Centered Medical Home (PCMH) will not only contain and manage health care costs but, most importantly, will improve care. We also must shift from a volume to a value based payment system rewarding those health care providers who demonstrate accountable, efficient and safe quality medical care. We spent more than two-third of our health care resources on chronic disease management. We could stop the waste! Our patients need to understand that they have to share responsibility for their wellness care and treatment. Joint accountability implies that physicians and patients are partners in the healthcare delivery process. I am optimistic that we can succeed improving our country's health care system.