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Editor's Note
Feb 11, 2013

Learning to Say No: Comment on “Snapshots of Low-Value Medical Care”

JAMA Intern Med. 2013;173(3):188. doi:10.1001/jamainternmed.2013.3381

A principal reason we started the “Less Is More” series was to stimulate consideration of, and discussion of, the strong culture in American medicine that promotes the “more health care can't hurt” philosophy. In this Viewpoint, an internist/epidemiologist relates how hard it is to turn down such care, even when you are a well-informed physician and you know you feel fine and most likely don't need the extra test, in this case magnetic resonance imaging. A reminder to focus on addressing the issue the patient came into your office about is a good start. And, of course, a discussion of the chances of benefit and the chances of harm associated with additional tests or therapies helps patients (and us) to make informed decisions and decline low-value care.