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Encouraging questions about healthcare: the next stage from Choosing Wisely Australia

Around the world, one of the goals of the Choosing Wisely movement is to change the big-picture conversations around healthcare – to question the ingrained assumption that “more” healthcare is always better.

Next week, Choosing Wisely Australia will release more than 60 new recommendations about tests, procedures and treatments whose use is worth questioning.

It’s timely therefore that Choosing Wisely Australia is working with Consumers Health Forum to raise community awareness about the importance of asking questions about healthcare.

However, this is not always an easy ask, as suggested in the article below by Dr Lynn Weekes AM, the CEO of NPS MedicineWise.

[divide style=”dots” width=”medium”]

Lynne Weekes writes:

Lynn WeekesChoosing Wisely Australia, like its predecessor in the USA, exhorts the importance of conversations between clinicians and health consumers.

When we suggested to our NPS MedicineWise Consumer Advisory Group that we want to encourage consumers to ask whether a test, procedure or treatment is needed, one very savvy and experienced member said, “I’ll ask when I see a sign in the surgery telling me it’s OK to ask”.

And it seems from our subsequent research that her view is shared by many people.

Recently we interviewed consumers about the factors that helped or hindered them in having conversations and asking questions of their doctor. People had an awareness that inappropriate and duplicate testing occurs in some situations. They said they sometimes felt a test or script was a way to get them out of the doctor’s office. They understood the time pressures doctors face and that medicine is complex and their doctor cannot know everything.

People did not want to see waste in the health system and thought we needed to have more education and awareness campaigns to provide health consumers with the questions they might want to discuss with their doctor.

The people we spoke with said there were three main things that impacted on if, or when, they would ask questions of their doctor.

Firstly, they wanted their doctor to make the ultimate choice or recommendation and they needed to be clear about their own role in coming to that recommendation.

Secondly, trust was critical and so knowing the doctor well and feeling that he or she was approachable and would welcome a question was really important.

Thirdly, knowing the right words and the right sort of questions would give people confidence that their question wasn’t foolish or irrelevant.

One of the insights from our research was people do not always understand that ‘doing nothing’ is in fact often ‘doing something’ and indeed, doing the right thing.

Leaving a healthcare appointment with knowledge of how to manage your condition based on solid advice and good evidence may be of greater value than leaving with a script or referral for a test.

Watchful waiting is an active process for the clinician that includes monitoring and yet may appear to be doing nothing if it is not well explained. In the end, it all comes down to communication.

Choosing Wisely Australia is working with Consumers Health Forum to raise community awareness about the importance of having conversations with their health professionals.

To assist these conversations, we have drawn up five questions for people to ask their doctor next time they are ordered a new medicine or test. These questions have been translated into 10 community languages and we are developing resources to set out what is meant by the items listed by the medical colleges about tests, procedures and treatments that are low value or that could cause harm.

We are also working with trusted online health information destinations like Healthdirect to ensure our messages are reaching the community

On March 16, Choosing Wisely Australia will release over 60 new recommendations from colleges, societies and associations about tests, procedures and treatments clinicians believe should be questioned.

It’s a great time to start a conversation with your health care provider and don’t be surprised to see a poster encouraging you to ask your doctor questions next time you visit.

• Dr Lynn Weekes AM is CEO NPS MedicineWise

About Choosing Wisely

Choosing Wisely Australia® is enabling clinicians, consumers and healthcare stakeholders to start important conversations about tests, treatments and procedures where evidence shows they provide no benefit and in some cases, lead to harm. The campaign is being led Australia’s medical colleges and societies and is facilitated by NPS MedicineWise. For more information go to www.choosingwisely.org.au.

5Qs

Previous stories at Croakey

Choosing Wisely and health services research

 • Choosing wisely with the Naked Doctor

 • Choosing Wisely: what can we learn from the US

Watch the CHF’s Leanne Wells from the launch of Choosing Wisely Australia last year