Nuance And The Healthcare Apocalypse

(Updated) If you actually have a life you may not be aware that there’s been a fierce debate on Twitter and the blogosphere over Lisa Rosenbaum’s NEJM article decrying the oversimplification and self-righteousness of the “less is more crusade.”  In response to fierce criticism, from myself, the Lown Institute, and others, Saurabh Jha praised and defended Rosenbaum for embracing nuance…

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Ms. Inappropriate Defends The Status Quo

I think I would have liked the younger Lisa Rosenbaum, the cardiologist who last week in the New England Journal of Medicine launched a missile at the “less is more” movement. Here’s how her piece begins: They called me Ms. Appropriate. When I was a cardiology fellow, health care costs were skyrocketing, and I considered devoting…

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Cardiology Group Withdraws ‘Choosing Wisely’ Recommendation

In the end it wasn’t wisdom for the ages. The American College of Cardiology said today that it was withdrawing one of its five recommendations in the “Choosing Wisely” campaign.  In 2012 the ACC recommended that heart attack patients should have only their culprit artery unblocked. It said that patients and caregivers should question whether complete revascularization of all…

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Medical Societies Release Lists of Overused Tests and Procedures

The American College of Cardiology (ACC) and other medical societies have released lists of commonly overused or misused tests of procedures. The action is part of Choosing Wisely, a broad initiative from the ABIM foundation. Here are the five tests or procedures identified by the ACC: Cardiac imaging tests (particularly, stress tests or advanced non-invasive imaging)…

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