Letter to Editor,
Explore This IssueACEP Now: Vol 35 – No 08 – August 2016
I was somewhat disappointed by the comments from practicing emergency physicians. Their reluctance to implement the test ordering approach suggested by the Choosing Wisely project seemed to be fixed on self-protection at the patient’s (and society’s) expense.
I am sure Dr. Lozanoff is correct when he says more testing results is better survey results, but unnecessary testing also results in an expense, increased incidence of “incidentalomas,” and a sense of empowerment given to the patient. The latter result causes a continual increase in expectations for more testing on subsequent visits. Perhaps better patient education could substitute for unnecessary testing.
Dr. Fisher seems to want immunity from malpractice liability in exchange for more appropriate testing patterns. I do not see how we, as professionals, can disconnect our “rights” (immunity) from our responsibility to “do no (economic) harm.”
Finally, I am not aware of any data that show a clear association between increasing testing and decreasing lawsuits.
Bruce D. Janiak, MD, FACEP, FAAP, professor, Augusta University