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April 23/30, 2014

How Neurologists Can Choose (Even More) WiselyPrioritizing Waste Reduction Targets and Identifying Gaps in Knowledge

Author Affiliations
  • 1Health Services Research Program, Department of Neurology, University of Michigan, Ann Arbor
  • 2A. Alfred Taubman Medical Research Institute, Department of Neurology, University of Michigan, Ann Arbor
JAMA. 2014;311(16):1607-1608. doi:10.1001/jama.2014.1021

Health care accounts for a large, and escalating, proportion of the gross domestic product, yet the overall value of many of these expenditures is unclear. The Institute of Medicine estimates that $750 billion could be saved annually by reducing health care inefficiencies, including $210 billion by eliminating unnecessary services.1 A recent attempt to reduce these unnecessary services, the Choosing Wisely campaign aims to stimulate a conversation between physicians and patients about the necessity of tests, procedures, and medications. The initial Choosing Wisely lists, including 1 from the American Academy of Neurology (AAN),2 represent an essential first step in the reduction of waste. Moving forward, physicians can choose even more wisely. To do so requires a framework for the complex task of prioritizing waste reduction targets out of the innumerable combination of tests, procedures, and medications.

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