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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,
JAMA Internal Medicine – American Medical Association
Published: Jul 1, 2014
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