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Bringing High-Value Care to the Inpatient Teaching Service

Bringing High-Value Care to the Inpatient Teaching Service Opinion Bringing High-Value Care to the Inpatient VIEWPOINT Teaching Service High-value care is a strategic priority of major aca- tors—not somebody else—have to make the tough de- Gurpreet Dhaliwal, MD demic and medical organizations. One of the greatest cisions in allocating them. I try to catch myself in mo- Department of challenges training programs face is fostering practice ments of exceptionalism such as “but our patients are Medicine, University of patterns in young physicians that avoid tests and treat- sicker” or “those study results do not apply to our pa- California, San ments of dubious value. tient.” At times such phrases are true, but if I find my- Francisco, and Medical Service, San Francisco We now have high-quality curricula and elegant self uttering them repeatedly, I recognize that I am es- Veterans Affairs campaigns to help residents grapple with a previously sentially saying, “high-value care is a good idea…for Medical Center, San neglected notion: that much of what we do in medicine somebody else’s patients.” Aphorisms like “when in Francisco, California. is wasteful and sometimes harmful. This formal curricu- doubt, rule it out” or “let’s play it safe” have to be re- lum is essential to signal new values, http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png JAMA Internal Medicine American Medical Association

Bringing High-Value Care to the Inpatient Teaching Service

JAMA Internal Medicine , Volume 174 (7) – Jul 1, 2014

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Publisher
American Medical Association
Copyright
Copyright 2014 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Restrictions Apply to Government Use.
ISSN
2168-6106
eISSN
2168-6114
DOI
10.1001/jamainternmed.2014.2012
pmid
24862304
Publisher site
See Article on Publisher Site

Abstract

Opinion Bringing High-Value Care to the Inpatient VIEWPOINT Teaching Service High-value care is a strategic priority of major aca- tors—not somebody else—have to make the tough de- Gurpreet Dhaliwal, MD demic and medical organizations. One of the greatest cisions in allocating them. I try to catch myself in mo- Department of challenges training programs face is fostering practice ments of exceptionalism such as “but our patients are Medicine, University of patterns in young physicians that avoid tests and treat- sicker” or “those study results do not apply to our pa- California, San ments of dubious value. tient.” At times such phrases are true, but if I find my- Francisco, and Medical Service, San Francisco We now have high-quality curricula and elegant self uttering them repeatedly, I recognize that I am es- Veterans Affairs campaigns to help residents grapple with a previously sentially saying, “high-value care is a good idea…for Medical Center, San neglected notion: that much of what we do in medicine somebody else’s patients.” Aphorisms like “when in Francisco, California. is wasteful and sometimes harmful. This formal curricu- doubt, rule it out” or “let’s play it safe” have to be re- lum is essential to signal new values,

Journal

JAMA Internal MedicineAmerican Medical Association

Published: Jul 1, 2014

References