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Medicare Patients Undergoing Cataract Surgery Original Investigation Research Invited Commentary Are We Choosing Wisely or Is This Simply Low-Value Care? Lee A. Fleisher, MD A major focus in fixing the health care crisis has been a shift the purposes of the surgical procedure. If the former was true, from volume-based to value-based care. One approach to im- then the incremental costs would be negligible compared with proving the value equation is the elimination of unnecessary those of routine care unless the consultation led to additional or wasteful tests and procedures. This forms part of the basis laboratory tests being obtained solely for the purpose of clear- of the Choosing Wisely campaign from the American Board of ing the patient for the surgical procedure. If no tests were ob- Internal Medicine Foundation. A major theme within the tained, then clearly the consultation could be considered part Choosing Wisely campaign has been the elimination of rou- of routine care. However, if the consultation was performed tine preoperative evaluation in low-risk patients. Given that solely for the purpose of an evaluation for the surgical proce- 30 million Americans undergo surgery annually and approxi- dure, then such additional medical services could be consid-
JAMA Internal Medicine – American Medical Association
Published: Mar 1, 2014
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