Surgeon inserting tube into patient during surgery

blog

August 9, 2012

A Cure for Overtreatment: RAND Guidelines for Appropriate Care

Photo by Monkey Business Images/Getty Images

by Arthur L. Kellermann

An article in Monday's New York Times calls attention to the incentives that exist in our medical system for providers to perform more procedures (in this case cardiac surgeries) on patients, sometimes irrespective of the medical necessity. It also reminds us that we cannot effectively address the problem of the rising cost of health care without eliminating wasteful and unnecessary care.

In a 2009 commentary in the Journal of the American Medical Association titled, "Assessing the Appropriateness of Care — Its Time Has Come," RAND's Bob Brook issued a strong call for the development of explicit criteria to determine the appropriateness of care patients receive. He offered, as a positive example, the RAND/University of California Los Angeles (UCLA) Appropriateness Method (RUAM) as an effective strategy to ensure that patients only receive the care they need, rather than costly treatment of unclear value or potential harm.

Reducing inappropriate and wasteful tests, treatments and procedures has the potential to save billions annually and simultaneously improve the quality and safety of American medicine.