Choosing Wisely

Having recently completed the 2016 survey regarding topics to be considered in the updated ASCP Choosing Wisely campaign, there were several thoughts that came to mind.

First, I applaud the ASCP for taking the initiative to participate early on with Choosing Wisely and now to review and update these elements. As we all know, as the evidence and needs of our patients change, so must we. We should always strive to maintain the “latest and greatest” particularly given the continued growth of laboratory medicine. Identifying appropriate and necessary laboratory utilization shows our concern as individual practitioners and as a professional society. Our involvement clearly influences patient outcomes and we must remain diligent about putting forth this message.

Secondly, I will admit that there were numerous tests and the questions regarding their usefulness listed in the Survey that were completely unfamiliar to me. This highlighted how lab menus are expanding and many of these were subspecialty oriented, pointing out how intricate and complicated our scope of laboratory practice has become. With the multitude of tests available and their complexity, is it any wonder our clinical colleagues suffer the same, and I venture to say even MORE, angst than we face given this array of testing options? Therefore it is even more important, then, that we as a Society continue to be about the forefront of laboratory initiatives, educating ourselves and helping those healthcare providers that live outside “our walls.”

Of course, the Choosing Wisely campaign is also focused on patients and the information needed for solid patient-centered decision-making. It is thus incumbent upon us to participate in this national campaign, for who better than laboratory professionals to help navigate these waters on the behalf of patients?

The onus is upon us, then, to pursue this initiative and provide guidance regarding laboratory utilization, appropriate testing, testing intervals, adequate test menus and laboratory interpretation. The ASCP participation in the Choosing Wisely campaign allows us to solidly insert our expertise in this arena. Each of us, as members, is responsible for our participation, not just in this Survey, but on an ongoing daily basis as part of the patient care team.

-Dr. Burns was a private practice pathologist, and Medical Director for the Jewish Hospital Healthcare System in Louisville, KY. for 20 years. She has practiced both surgical and clinical pathology and has been an Assistant Clinical Professor at the University of Louisville. She is currently available for consulting in Patient Blood Management and Transfusion Medicine. You can reach her at cburnspbm@gmail.com.