High-Value, Cost-Conscious Care
Authors: Cynthia D. Smith
Journal: Annals of Internal Medicine (2013)

Letters15 January 2013High-Value, Cost-Conscious CareCynthia D. Smith, MDCynthia D. Smith, MDFrom American College of Physicians, Philadelphia, Pennsylvania.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-158-2-201301150-00027 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail IN RESPONSE:Dr. Kisloff expresses concern that there is insufficient high-quality evidence to provide a framework for instruction in providing high-value, cost-conscious care and cites studies on HIV, prostate-specific antigen, and breast cancer screening as examples. The complexity that surrounds many clinical decisions is precisely why this curriculum provides a framework for trainees to approach clinical decisions in an organized, stepwise fashion. It includes customizing the plan to reflect the individual patient's values and concerns while warning against the practice of one-size-fits-all medicine.Clinicians need to make decisions even when the available evidence is insufficient or controversial, and the curriculum ...References1. Chou R, Shekelle P, Qaseem A, Owens DK. Correction: Diagnosis and treatment of low back pain [Letter]. Ann Intern Med. 2008;148:247-8. [PMID: 18257154] LinkGoogle Scholar2. Jordan JE, Wippold FJ, Cornelius RS, Amin-Hanjani S, Brunberg JA, Davis PC, De La Paz RL, et al; Expert Panel on Neurologic Imaging. ACR Appropriateness Criteria: Headache. Reston, VA: Am Coll Radiology; 2009:8. Google Scholar3. Centers for Medicare and Medicaid Services (CMS), HHS. Medicare program; hospital inpatient prospective payment systems for acute care hospitals and the long-term care hospital prospective payment system and FY 2012 rates; hospitals' FTE resident caps for graduate medical education payment. Final rules. Fed Regist. 2011;76:51476-846. [PMID: 21894648] MedlineGoogle Scholar4. Babbott SF, Beasley BW, Hinchey KT, Blotzer JW, Holmboe ES. The predictive validity of the internal medicine in-training examination. Am J Med. 2007;120:735-40. [PMID: 17679136] CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAuthors: Cynthia D. Smith, MDAffiliations: From American College of Physicians, Philadelphia, Pennsylvania.Disclosures: Disclosures can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M12-1519. 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 , on behalf of the Alliance for Academic Internal Medicine–American College of Physicians High Value, Cost-Conscious Care Curriculum Development Committee* High-Value, Cost-Conscious Care Barry Kisloff High-Value, Cost-Conscious Care Vichai Atichartakarn Metrics Cited byIdentification of High Resource Utilizing Patients on Internal Medicine Hospital Services 15 January 2013Volume 158, Issue 2Page: 143-144KeywordsBreast cancer screeningChartsConflicts of interestDisclosureHeadachesHIVLaboratory testsLower back painMotivationPatients ePublished: 15 January 2013 Issue Published: 15 January 2013 Copyright & PermissionsCopyright © 2013 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...