Otolaryngology–Head and Neck Surgery (AAO-HNS) is one such participating organization, contributing many relatively obvious recommendations to the campaign, including the following: Do not order a computed tomography (CT) scan of the head and brain for sudden hearing loss, and do not prescribe oral antibiotics for uncomplicated acute tympanostomy tube otorrhea. While the specifics of the Choosing Wisely recommendations may be trivial, the program itself underscores a larger issue: Physicians have a responsibility as financial stewards in the management of healthcare costs. Such stewardship benefits patients individually and the system as a whole.
While the old paradigm of healthcare delivery focused on volume, the new paradigm centers around value (quality divided by cost).
Patients also participate in cost management. In particular, the ACA introduced price-sensitive consumers to the playing field. While the ACA has allowed for more individuals to receive insurance coverage, in some cases their insurance deductibles are between $3,000 and $6,000. This is a tremendous sum of money for many Americans, half of whom do not have enough money to meet such a large deductible, which results in a decrease in healthcare utilization and reduced revenue for the provider. Providers then respond by trying to compete by lowering cost, and insurance companies respond by dropping the higher cost physicians.