High-Value, Cost-Conscious Care
Authors: Barry Kisloff
Journal: Annals of Internal Medicine (2013)

Letters15 January 2013High-Value, Cost-Conscious CareBarry Kisloff, MDBarry Kisloff, MDFrom University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-158-2-201301150-00025 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:Smith and colleagues' article (1) about the creation of a curriculum to instruct physicians in the provision of “high-value, cost-conscious care” makes several assumptions of dubious validity. There is the unfounded belief that sufficient high-quality, evidence-based pathways exist to provide a framework of instruction toward this goal. Most commonly encountered health care issues are engulfed in legitimate controversy (2–4), and with ongoing research, an evidence-based pathway that has modest validity today might well have little legitimacy in the near future. Providing even the best-supported recommendation for an evidence-based pathway must still be tempered by patient preference (5) ...References1. Smith CD; Alliance for Academic Internal Medicine-American College of Physicians High Value. Teaching high-value, cost-conscious care to residents: the Alliance for Academic Internal Medicine-American College of Physicians Curriculum. Ann Intern Med. 2012;157:284-6. [PMID: 22777503] AbstractGoogle Scholar2. Bayer R, Oppenheimer GM. Routine HIV screening—what counts in evidence-based policy? N Engl J Med. 2011;365:1265-8. [PMID: 21991946] CrossrefMedlineGoogle Scholar3. Sox HC. Quality of life and guidelines for PSA screening [Editorial]. N Engl J Med. 2012;367:669-71. [PMID: 22894580] CrossrefMedlineGoogle Scholar4. Gøtzsche PC, Olsen O. Is screening for breast cancer with mammography justifiable? Lancet. 2000;355:129-34. [PMID: 10675181] CrossrefMedlineGoogle Scholar5. Quill TE, Holloway RG. Evidence, preferences, recommendations—finding the right balance in patient care. N Engl J Med. 2012;366:1653-5. [PMID: 22551123] CrossrefMedlineGoogle Scholar6. Rauh SS, Wadsworth EB, Weeks WB, Weinstein JN. The savings illusion—why clinical quality improvement fails to deliver bottom-line results. N Engl J Med. 2011;365:48. [PMID: 22168591] CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: From University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania.Disclosures: None disclosed. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoTeaching High-Value, Cost-Conscious Care to Residents: The Alliance for Academic Internal Medicine–American College of Physicians Curriculum Cynthia D. Smith and High-Value, Cost-Conscious Care Vichai Atichartakarn High-Value, Cost-Conscious Care Cynthia D. Smith Metrics 15 January 2013Volume 158, Issue 2Page: 142-143KeywordsAcademic medicineConflicts of interestForecastingHealth careMotivation ePublished: 15 January 2013 Issue Published: 15 January 2013 CopyrightCopyright © 2013 by American College of Physicians. All Rights Reserved.PDF DownloadLoading ...