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Dr. John Santa 
A Busy Fall for Choosing Wisely

ABIM Foundation, Consumer Reports and multiple professional societies are working on the third wave of Choosing Wisely topics over the next few months. This time, each society is announcing its topics separately. From what we have seen, the topics will continue to inform physicians and consumers of common circumstances in which tests and treatments may be overused and may lead to concerns about safety and waste.

Here are several strong examples, from the announcements already made this month:

 AMDA,  the professional society focused on long term care, points to the overuse of cholesterol-lowering medications in patients over 70. The risks and benefits of these drugs change as patient's age. Benefits decrease, risks increase. They are not for everyone -- especially patients in their 80s.
 The Commission on Cancer, a collaboration of 50 professional organizations, urges that a needle biopsy of a suspicious breast lump be done before more invasive surgery removing the lump. Needle biopsy is a safe, accurate and much less invasive procedure. Unnecessary surgery can be avoided.
 The American College of Surgeons endorses a less invasive approach to determining if breast cancer has spread to the lymph nodes. It is called sentinel node biopsy. If these nodes, the ones closest to the breast, are negative, then no further invasive surgery is needed, saving the patients from possible chronic swelling of the arm. When it comes to surgery, less can be more.
 The American Academy of Orthopaedic Surgeons says not to use glucosamine and chondroitin to treat patients with symptomatic osteoarthritis of the knee. These supplements are widely advertised and promoted. They may cause problems without providing any benefit.  
 The Society of General Internal Medicine, an organization of 3000 physicians who teach and do research related to primary care and internal medicine, says: "Don't perform routine general health checks for asymptomatic adults." The annual physical may confuse more often than clarify.

There will be many more to come. Our job is to get this important information out to consumers, and we hope you will help us do that. Consumers need to hear multiple times in multiple ways that too much health care can be as dangerous as too little. Good health care gives us the right amount of health care -- no more, no less than we need.

John Santa, M.D

Director, Consumer Reports Health Ratings Center


September 2013 Newsletter
In this issue:
What' New
Campaign Updates
Partner Spotlight
Quick Links


What's New

A New Tool for Consumers 


Consumer Reports is developing a digital tool to help consumers
understand how the new healthcare law, going into effect
January 1, 2014, will affect them and their families. Open
enrollment for millions of Americans begins on October 1, 2013.

The new tool, which we are providing free of charge, brings
Consumer Reports' trusted name, unbiased analysis and
strong brand recognition to engage a wide audience matching
the massive sweep and impact of the ACA.

The primary objective of the web tool is to provide consumers with
unbiased and simple guidance so they know what they need to
know to be in compliance with new healthcare requirements, are
aware of any new options available to them, and how, where and
when to take appropriate action. The tool is being designed for mobile,
tablet and desktop, and will be available in both English and Spanish versions.
We will also be including some user stories around healthcare to help
provide context and social sharing.

Uniquely, the tool fills a need for expert, independent
healthcare advice that is customized to a given consumer's
particular circumstances based on information the user provides.
The tool has been built using consumer testing to ensure we are
adequately communicating the necessary information consumers
want and need.

Please contact Dom Lorusso if you are interested in linking to the tool.

Stayed tuned for the release!

Campaign Updates
Choosing Wisely Phase Three Launch


The Choosing Wisely campaign will enter its third phase in September,
with leading medical specialty societies releasing more than 30 new
lists of specific tests or procedures they say are commonly ordered but
not always necessary that could cause harm. Read the press release here.

This phase will include 9 medical societies releasing lists in September,
with additional lists being released each month through early 2014.
The Choosing Wisely campaign brings together national physician groups
to develop evidence-based lists of five tests and procedures that may be
overused in their specific field. Consumer Reports Health will continue to review 
the lists and develop consumer education material for those items on the list
which are most relevant to consumers. In addition, Consumer Reports, which
is the official "Consumer Communicator" for the campaign, continues to work
with their partners to get this information into the hands of consumers nationwide.
Some of the societies releasing their lists over the next couple of months include
the American Academy of Orthopaedic Surgeons, the American Psychiatric
Association and the American College of Emergency Physicians.

These new lists build on the library of more than 130 tests and procedures that
have been identified as potentially harmful and should be discussed with patients
and physicians. To date, 54 societies and 17 consumer groups have joined the
Choosing Wisely effort, and over 50 consumer pieces have been developed.
Learn more about Consumer Reports role in the campaign here.

Partner Spotlight 

Announcing a NEW Partnership  


Consumer Reports Health is proud to announce that Covered California,

or the California Health Exchange, has joined the Choosing Wisely campaign
as an official campaign partner, joining the 16 other organizations, helping
Consumer Reports deliver these important messages to consumers.

California, which was the first state to create a health benefit exchange following
the passage of the federal health care law, has charged Covered California with
creating a new insurance marketplace, in which individuals and small businesses
can get access to health insurance. With coverage starting in 2014, Covered California 

will help individuals compare and choose a health plan that works best for their
health needs and budget. Financial help will be available from the federal government

to help lower costs for people who qualify on a sliding scale. Small businesses will be 

able to purchase competitively priced health plans and offer their employees the ability 

to choose from an array of plans and may qualify for federal tax credits. Covered California 

is an independent part of state government whose job is to make the new market work for 

California's consumers. It is overseen by a five-member board appointed by the governor 

and legislature. For more information on Covered California, please visit 


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