Coming to a DHB near you: patient choice

One in five New Zealanders think their doctor has recommended a test or treatment that wasn’t necessary for their health, a survey by Consumer NZ and the Council of Medical Colleges has found. The survey was carried out as part of the international Choosing Wisely campaign, which was introduced to the eye care world at the Royal Australian and New Zealand College of Ophthalmologists (RANZCO) New Zealand Branch annual scientific meeting.

Nelson-based ophthalmologist Dr Derek Sherwood, Council of Medical Colleges chair, shared Choosing Wisely patient cards among delegates and took to the podium to explain how Choosing Wisely was designed to reduce the use of unnecessary or unevidenced medical tests and procedures.

It’s about making a cultural change, he said, to reduce opportunistic screenings and other tests, procedures or medications, such as antibiotics, where the cost of doing them does not provide a proportional benefit or where there is little or no real health benefit.

“There is mounting evidence that more tests and procedures don’t always equal better care. While modern medicine has given us more ways than ever to diagnose and treat illness, sometimes, the best option may be to do nothing.”

The patient card encourages patients to discuss their care with their medical advisor by suggesting they ask four questions before undergoing any health tests:

• Why am I having this test?
• What information will it provide?
• What are the risks of the test?
• What happens if I don’t have the test?

“With the advent of many advanced methods to test for various eye health issues, it is important for any eye care practitioner to communicate effectively what tests are appropriate and how frequently they need to be performed,” said Dr Lesley Frederikson, national director of the New Zealand Association of Optometrists.

In the Consumer NZ survey, of those who felt their doctor had recommended an unnecessary test or treatment, nearly 20% said they went ahead and had it anyway, rather than talk with their doctor about why it was necessary, while 22% ignored their doctor’s recommendation. Overall, 35% of consumers felt some tests or treatments did not benefit them.Sue Chetwin, Consumer NZ chief executive, said consumers should feel able to ask their doctor questions so they can make informed decisions. “Health care choices can have major implications.”

Choosing Wisely is in 22 countries, including the USA, Canada, the UK, Australia and now, New Zealand. As well as encouraging patients to ask health professionals about tests and treatments, the Choosing Wisely campaign has comprehensive information for health professionals about which tests, treatments and procedures to question.Here, Choosing Wisely is sponsored by the Council of Medical Colleges, of which RANZCO is a member, Southern Cross Health Society, Pacific Radiology and Pharmac. Consumer NZ and the Health Quality & Safety Commission are Choosing Wisely partners.