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Letters |

Decreasing the Frequency of Ordering Tests or Treatments

Kieran Walsh, FRCPI, FHEA
JAMA. 2013;309(6):546-547. doi:10.1001/jama.2012.113514.
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To the Editor: Drs Detsky and Verma1 made a number of suggestions about how students and residents could be encouraged to show more restraint when ordering tests or treatments. Their idea that individual acts of restraint should be celebrated is innovative; however, whether such tactical actions on their own would have a major effect without a more strategic approach is questionable.

Such a strategic approach might involve medical schools and residency programs radically rethinking their educational curricula, delivery, and assessments so that restraint in the delivery of care is integrated into all aspects of the programs. The curricula could be rewritten so that prominent curriculum statements included competencies such as “knows when ordering tests is inappropriate or counterproductive” or “knows when to stop treatments.”

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February 13, 2013
Allan S. Detsky, MD, PhD; Amol A. Verma, MD, MPhil
JAMA. 2013;309(6):546-547. doi:10.1001/jama.2012.113527.
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