Chris Moriates's guest appearances

Chris Moriates

Teaching Value in Health Care

GeriPal

Arif Kamal

Vinny Arora

Jennifer Myers

BJ Miller

Andy Cohen

Aaron Kesselheim

Johns Hopkins

Louise Aronson

Steve Brown

Heather Smith

Haider Warraich

Lewis Cohen

Stephanie Rogers

Tim Anderson

Jessica Zitter

OwlTail

You're the attending physician on a teaching service. Your resident says we shouldn't order a CT because CT's are over-used for this condition, and represent overuse, waste, and low-value care. In this case, however, you suspect that's not the resident's real reason. The real reason behind the resident's decision is that they are serial minimizers - residents who make little of potentially important findings. You feel they might be hiding their minimizing behind the sexy, trendy notion of providing "high value care." Does this sound familiar to you? It did to me. I've been in the awkward situation of being the consulting palliative care physician saying to the primary team, I know they have cancer and that's the most likely explanation for this abdominal pain. I also worry that this pain is out of proportion and different from other pain I've seen, and I think it should be evaluated with further testing. Kind of strange to say that as the palliative care doctor. Kind of strange as well to hear that perspective exposed by Chris Moriates and Vinny Arora, who spend most of their academic careers fighting against wasteful low-value tests and treatments (they run a non-profit called Costs of Care). To be sure, they note this problem is not as great as overuse of consultants, tests, and treatment. The challenge, as Stephanie Rogers our guest host (and guest fiddle player!) points out, is coming up with the right words to teach "right sizing" care to the patient in front of us. And what are the root causes of minimizing? Blame the house staff would be the easy way out, but Chris and Vinny don't take that road. Read more about their thoughts in this article in the Journal of Hospital Medicine and listen to or read our podcast! -Alex @AlexSmithMD Note: For links to referenced articles as well as a transcript of this episode, please visit our blog page at geripal.org/2019/09/hiding-behind-high-value-care-podcast.html

You're the attending physician on a teaching service. Your resident says we shouldn't order a CT because CT's are over-used for this condition, and represent overuse, waste, and low-value care. In this case, however, you suspect that's not the resident's real reason. The real reason behind the resident's decision is that they are serial minimizers - residents who make little of potentially important findings. You feel they might be hiding their minimizing behind the sexy, trendy notion of providing "high value care." Does this sound familiar to you? It did to me. I've been in the awkward situation of being the consulting palliative care physician saying to the primary team, I know they have cancer and that's the most likely explanation for this abdominal pain. I also worry that this pain is out of proportion and different from other pain I've seen, and I think it should be evaluated with further testing. Kind of strange to say that as the palliative care doctor. Kind of strange as well to hear that perspective exposed by Chris Moriates and Vinny Arora, who spend most of their academic careers fighting against wasteful low-value tests and treatments (they run a non-profit called Costs of Care). To be sure, they note this problem is not as great as overuse of consultants, tests, and treatment. The challenge, as Stephanie Rogers our guest host (and guest fiddle player!) points out, is coming up with the right words to teach "right sizing" care to the patient in front of us. And what are the root causes of minimizing? Blame the house staff would be the easy way out, but Chris and Vinny don't take that road. Read more about their thoughts in this article in the Journal of Hospital Medicine and listen to or read our podcast! -Alex @AlexSmithMD Note: For links to referenced articles as well as a transcript of this episode, please visit our blog page at <a href="http://geripal.org/2019/09/hiding-behind-high-value-care-podcast.html" rel="nofollow" target="_blank">geripal.org/2019/09/hiding-behind-high-value-care-podcast.html</a>

Hiding Behind High Value Care: A Podcast with Vinny Arora and Chris Moriates

Zack Timmons

Dr. Chris Moriates and med students Will Squires and Zack Timmons discuss the Choosing Wisely STARS program with Costs of Care Fellow Arjun Gupta and share tips for integrating it into a curriculum.

Will Squires, Zack Timmons and Dr. Chris Moriates - Choosing Wisely STARS