There are roadblocks to implementing recommendations from the Choosing Wisely campaign, which aims to reduce unnecessary tests, treatments and care, according to a report published in the Journal of General Internal Medicine.
The survey includes responses from 603 primary care physicians in the United States and 1,173 VA primary care providers. The primary care physicians were asked about whether Choosing Wisely recommendations for screening, testing and treating adult patients were difficult to follow and potential barriers to reducing overutilization.
The researchers found:
1. Most of the primary care physicians were able to follow the recommendations on not screening or testing asymptomatic patients — only 20 percent found them difficult to accept or difficult for patients to follow.
2. There are five recommendations on treating symptomatic conditions and 9.8 percent to 32 percent of physicians found them difficult to follow.
3. Patients found it more difficult to accept Choosing Wisely recommendations for testing and treating symptomatic conditions; 35.7 percent to 87.1 percent reported difficulty accepting those measures.
4. The biggest barriers reported include:
• Malpractice concerns
• Patient request for services
• No time for shared decision making
• Number of tests specialists recommend
5. The study authors advised that, "Overcoming PCPs' perceptions of patient acceptability will require approaches beyond routine physician education, feedback and financial incentives."