Getting Physicians and Patients to Choose Wisely: Does the Law Help or Hurt?

Abstract

This paper is a contribution to the University of Toledo symposium entitled Scalpel to Gavel: Exploring the Modern State of Health Law. It begins with a description of one significant large-scale initiative aimed at encouraging more rational, evidence-based medical practice, namely, the in-progress Choosing Wisely® movement initiated by the American Board of Internal Medicine and Consumer Reports and endorsed by numerous medical specialty organizations. Next is a discussion of legal anxieties as a powerful impediment to physicians’ rationalizing of medicine, and the article concludes by presenting some ideas for responding to the impediment to more rational medicine created by physicians’ litigation and liability-related apprehensions associated with evidence-based medicine changes in the scope and aggressiveness of patient care.