Teaching Value Project Aims to Reduce Health Care Waste

PHILADELPHIA - Despite estimates that more than $700 billion is wasted each year on duplicative or unnecessary care that may not improve people's health, our medical education system does not train physicians to understand how ordering tests and procedures that may not be necessary can harm patients and can directly affect costs for patients and the system. Research shows this lack of knowledge has profound consequences, as 62% of all personal bankruptcies are related to medical expenses (1).

To begin educating physicians and reduce wasteful practices, the Teaching Value Project, an initiative of Costs of Care and funded by the ABIM Foundation, brought together a multidisciplinary group of medical educators and health economists to create a series of Web-based video modules that illustrate core principles of resource stewardship.

The modules center on the care of a fictional patient admitted to the emergency room and explore 10 reasons why clinicians commonly overuse medical tests and treatments, including how physicians are trained, opaque pricing structures, redundant ordering and patient requests. Each scenario is coupled with a debriefing video that includes key teaching points, including how to communicate with patients about avoiding unnecessary care and reducing overused or misused tests and procedures.

"For too long, doing more was equated with being a good doctor," said Neel Shah, MD, Founder and Executive Director of Costs of Care. "We need to help physicians-especially those early in their careers-understand how their decisions on a day-to-day basis can reduce wasteful practices and improve the care we deliver to patients."

The modules, now available at www.teachingvalue.org, are intended to engage trainees in graduate medical education programs, and will also be used for training both faculty and other practicing physicians in teaching hospitals, as well as students. Medical educators, including course directors, librarians and compliance officers can use the certification process built into the modules to demonstrate competency in value-based clinical care.

The Teaching Value Project was funded by an ABIM Foundation Putting the Charter into Practice grant. This program provides financial support to physicians working in professional medical organizations, health systems/hospitals, academic medical centers and medical practices as they work to advance medical professionalism. In 2011, five grants were awarded to facilitate the development of innovative, emerging strategies to advance appropriate health care decision-making and stewardship of health care resources, one of the commitments of Medical Professionalism in the New Millennium: A Physician Charter.

The Teaching Value Project complements the Teaching Value and Choosing Wisely competition announced in April. The goal of this effort is to address gaps in medical education to learn how to deliver the highest quality care at the lowest possible cost and identify the most promising innovations and bright ideas that can be successfully implemented on a larger scale. Competition winners will be invited to share their innovations at an ABIM Foundation meeting in November.

The teaching points demonstrated in the modules also help physicians advance the goals of the ABIM Foundation's Choosing Wisely® campaign. First launched in 2012 with nine medical specialty societies and Consumer Reports, the campaign encourages physicians, patients and other health care providers to engage in conversations about overused and wasteful tests and procedures. In February 2013, an additional 17 societies announced lists and nearly 30 more have joined and will release lists in late 2013 and early 2014.

More information about Costs of Care and the Teaching Value Project can be found at www.teachingvalue.org.


(1) Himmelstein DU, Thorne D, Warren E, Woolhandler S. Medical bankruptcy in the United States, 2007: results of a national study. Am J Med [Internet]. 2009 Aug [cited 2013 May 23];122(8):741–6. Available from: http://www.ncbi.nlm.nih.gov/pubmed/19501347


About the ABIM Foundation
The mission of the ABIM Foundation is to advance medical professionalism to improve the health care system. We achieve this by collaborating with physicians and physician leaders, medical trainees, health care delivery systems, payers, policy makers, consumer organizations and patients to foster a shared understanding of professionalism and how they can adopt the tenets of professionalism in practice. To learn more about the ABIM Foundation, visit www.abimfoundation.org, read the Medical Professionalism Blog, connect with us on Facebook or follow us on Twitter.

About Costs of Care
Costs of Care is a 501c3 nonprofit organization that gives cost-conscious care providers the information they need to provide high value care, while expanding the national discourse on the role of care providers in responsible resource stewardship. Learn more at www.costsofcare.org.