In April, the American Board of Internal Medicine (ABIM) Foundation kicked off Choosing Wisely, its initiative aimed at encouraging patients to ensure the medical tests or procedures they are undergoing are shown to be medically necessary. With so many procedures, tests and treatment options available to mesothelioma patients, it is critical that time, resources and money not be wasted on potentially unnecessary tests.
Choosing Wisely has been gaining momentum. Since the initial set of questions posed by nine specialties, including oncology, was published, other medical specialty groups have been coming on board. This week, the American Academy of Hospice and Palliative Medicine (AAHPM) announced it has formed a Choosing Wisely Task Force and will be publishing its list of "Five Things Physicians and Patients Should Question" in September. Caregivers and patients will be able to use these suggestions as they move into the palliative care phase of mesothelioma.
Mesothelioma is an aggressive, rare cancer caused by asbestos exposure that can be very difficult to diagnose. Once the disease has been identified, the patient is typically suffering from life-threatening complications. In advanced cases, the patient may turn to palliative care. Palliative care is aimed at relieving symptoms and keeping the patient comfortable and surrounded by loved ones without treating the cancer itself.
The Choosing Wisely initiative has tasked each medical specialty group to come up with five procedures that can be deemed unnecessary unless the patient meets specific requirements validating the need for the test. The procedures added to the list should currently carry a significant cost. There should also be "generally-accepted evidence" to support any item added to the list.
The AAHPM reports the task force will solicit input from its Special Interest Groups and will review the evidence supporting the recommendations to generate its list of "Five Things." In addition, all members of the AAHPM will be invited to comment on the list before it is finalized and submitted to the ABIM Foundation.
We always encourage mesothelioma patients to be empowered and to work closely with their oncologists and medical team to determine their best course of treatment. Choosing Wisely gives patients an opportunity to discuss the pros and cons of procedures based on medical evidence, and to decide with the doctor whether to move forward.
According to an article in Monday's Washington Post, Christine K. Cassel, president of the American Board of Internal Medicine agrees. "Choosing Wisely is not about eliminating tests but about deciding whether we need to do a test or treatment. Ultimately, when doctor and patient both agree to forgo a particular test, it is not rationed care; it is rational care," she said.
