Take the challenge

Friday, November 01, 2013 12:31 PM

Strengthen patient relationships and improve health care delivery

Gina Claxton, CMS contributing writer

Saying no to a patient can be one of the most challenging things a physician can do, and if done well it can often be the best thing for patients and physicians alike. The Colorado Medical Society continues to push forward on the statewide Choosing Wisely Colorado campaign created by and designed for physicians. The campaign supports physicians and their work to strengthen relationships with patients, improve health care delivery and change current practice habits.

Facing the challenge
Christie Reimer, MD, internist from Fort Collins and president of the Northern Colorado Medical Society (NCMS), knows the constraints all too well that physicians currently face to improve patient care efficiency, effectiveness and engagement. In a recent article for NCMS she not only recognizes these challenges, she also challenged the profession to consider when patients are harmed by too much health care by spotlighting Brandon Combs’ “Do No Harm Project” at the University of Colorado.  In thinking about the Choosing Wisely Colorado recommendations she notes that, “I am a general internist who strongly believes that every patient should have a meaningful relationship with a primary care physician…[and these recommendations] make me re-evaluate how I best care for well adults.”

Choosing Wisely Colorado (CWC) is the state-level effort championed by the Colorado Medical Society as part of the much larger national Choosing Wisely® movement. The initiative is spanning the country and growing in impact daily. Originally only nine medical specialty societies were involved in the campaign. Today, roughly one year from launch, over 50 specialty groups are committed to the campaign’s aim of increased efficiency in the use of our health care resources. CMS was the first state medical society to endorse Choosing Wisely®, and continues to support the efforts of encouraging communication around appropriate care to increase quality in health care delivery.

Doing what is best for Colorado patients and communities is what is at the core of the Choosing Wisely Colorado campaign. Kim Warner, MD, Denver OB/GYN with the Kaiser Permanente, explains, “The Choosing Wisely Colorado campaign is done with the intent to give you the tools to make the right choices for your patients. The focus is on patient-centered care.” Dr. Warner helped to create a CMS toolbox video for the Choosing Wisely campaign demonstrating some of the tips and techniques she uses to engage patients successfully in “no” conversations.

Perfect timing
Taking on the Choosing Wisely Colorado challenge now may be more important than ever. As a physician you have likely felt pressure from all directions to increase efficient use of health care resources, to reduce health care spending, and to protect patients from financially devastating out of pocket treatment costs. These pressures are not expected to relent because they are a direct by-product of the evolving health care environment and health care reform. While you may not be able to control many of those issues, Choosing Wisely Colorado provides resources for you to use on something that you have some control over – your relationships with your patients.

Choosing Wisely Colorado provides a vehicle for physicians to demonstrate both leadership and stewardship in the health care system. Taking on the challenge of Choosing Wisely Colorado acknowledges the fact that physicians are the health care experts, and the decisions you make have huge impacts on health outcomes and quality of care. Literature shows that meaningful conversations help to not only enrich physician/patient relationships, but also improves quality and safety.

The challenge also presents an avenue to demonstrate professional responsibility, an area in which Colorado physicians have shown a keen interest. In fact, a recent CMS poll showed the majority (63%) of Colorado physicians believe they have a major responsibility to take the lead in Choosing Wisely conversations.

Colorado Medical Society offers several tools and resources on the CWC web page. Visit www.cms.org/choosing-wisely for videos, articles, brochures, and patient resources surrounding these potentially difficult but very important Choosing Wisely conversations. New resources continue to be developed and added to the website. If your component or specialty society is interested in helping create a new tool or take the lead on the campaign please contact Chet Seward at chet_seward@cms.org.