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Choosing Wisely

Posted 2/25/2013

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  You likely have heard about the national initiative called "Choosing Wisely".  An initiative of the ABIM (American Board of Internal Medicine), this is a project focused on encouraging patients, physicians, and other stake holders to engage in the necessary conversations about choices. There are tests and procedures that often do not add value, and may cause harm. There is amore about this at

   This initiative covers all medical specialities, but cancer is a hot topic and a controversial one. In the interest of full disclosure, my husband, Lowell Schnipper, leads the ASCO task force that has been charged with identifying common practices in medical oncology that fit these guidelines and concerns. This matters a lot to our national health care debate, costs, and to each of us as individual patients.

  Another set of five choices/decisions has been announced by each medical speciality group, and this is an article from ASCO about the cancer report. I give you the beginning and a link:

When the diagnosis is cancer, many people

hen the diagnosis is cancer, many people

understandably want to pull out all the

stops to treat it. But some tests, treatments,

and procedures are not only unnecessary,

they can even prove harmful.

“Sometimes less really is more,” says Lowell

Schnipper, M.D., clinical director of the Cancer

Center and chief of oncology and hematology at

Beth Israel Deaconess Medical Center in Boston.

“It’s important to assess if what you are doing

will help you stay well longer.”

Schnipper heads a task force convened by the

American Society of Clinical Oncology (ASCO),

a professional group dedicated to cancer care

and research, that identified five tests and treatments

that are not supported by evidence for

most patients. That means you should generally

avoid them unless you and your doctor jointly

decide they are appropriate in your case.

“This is not a never list,” says Doug Blayney,

M.D., medical director at Stanford University

Cancer Institute in Stanford, Calif., past president

of ASCO, and also a member of the task

force. “It’s a tool to help you discuss options with

your provider and choose wisely among them.”


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