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When It Comes to Medical Care for Seniors, More Isn’t Usually Better

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Here’s one statistic that really infuriates us: according to many estimates, the dollar value of wasted health care in the U.S. is about one quarter of a trillion dollars per year. Yes, you read that right: many believe that as much as one-fifth of American medical care, amounting to roughly $250 billion per year, is unnecessary, mostly consisting of tests, procedures and prescriptions that not only do the patient no good but may actually be causing harm.

Tragically, the elderly are quite often on the receiving end of this unnecessary care. Seniors make up about one-seventh of the U.S. population but receive about one-third of the medical care; and since many seniors are already suffering from frailty and chronic medical conditions, the risks of being harmed by the health care system are dramatically increased among the aged. With all that as background, we highly recommend you take a look at this article that just appeared on the website Politico. The article is called, “Senior Medicine: When ‘More’ Isn’t Better.” It describes a nationwide initiative that is designed to slow down excessive care for seniors – a movement, the article says, that is “running into the culture (and business) of health care.”  It’s the familiar battle between patient-centered health care practitioners on one side and the combination of procedural inertia and the profit motive on the other.

The Politico article features a Washington D.C. based geriatrician named Dr. George Taler who is a proponent of the new initiative called Choosing Wisely.  “For four decades,” writes Politico, “Taler…has been trying to practice what he calls ‘slow medicine.’ His clients are elderly people with chronic disease, individuals who typically cost the health care system around 10 times more than the average patient. And at the center of his philosophy is the idea—radical in today’s medical environment—that less can be much more.” The Choosing Wisely initiative is one effort to force the medical establishment to do things differently, especially where seniors are concerned. It was launched in 2012 by the American Board of Internal Medicine Foundation, and is “based on the premise that the best outcomes often result from saying ‘no’ to tempting procedures, tests and prescriptions.”  So far 80 different medical and pharmaceutical societies in the U.S. have signed on, each (in the words of the Politico article) “creating lists of five to 10 things that their members shouldn’t do—at least without thoughtful discussion with the patient.” The article calls Choosing Wisely “a broad-based effort to figure out what patients don’t really need, and then ensure they don’t get it.”

Of course, this idea of cutting back on tests and procedures is getting some major pushback. For one thing, the article points out, not everyone agrees with all the guidelines and recommendations for a more cautious approach to care. But for another thing, those extra tests and procedures are highly profitable, and some are fighting back because they see an economic risk if programs like Choosing Wisely should take hold. For doctors who try to integrate those ideas into their practice, says the Politico analysis, “it’s clear that much of U.S. medicine is not embracing the principles of Choosing Wisely, which is colliding with a whole host of issues in medicine, from payment systems to the scattered way many patients receive their medical care, to a prevailing culture in which both doctors and patients have trouble saying ‘no’ to more medicine.” But clearly something has to give. “With health care accounting for a swelling chunk of the U.S. economy—about 18 percent at last count – if doctors and health systems can’t better shepherd our resources, bean counters may do it for them—in a way that no one likes.”

No one can say quite yet whether the Choosing Wisely campaign is having any measurable results in lowering health care costs, partly because the initiative hasn’t been around all that long. (By the way, the campaign does have its own website, and you can click here if you’re interested in more detail.) But there are several instances cited in the Politico article of individual hospitals that have seen the number of unnecessary medical tests (and their related costs) drop dramatically – a hopeful sign.

Here at AgingOptions, because we believe so strongly in the advantages of geriatric medicine for seniors, we were intrigued to read how enthused geriatric physicians are about this new program to reduce unneeded care. “If Choosing Wisely has a cheering section,” writes Politico, “it’s the geriatricians.” The article explains that, “In many instances, the geriatrician acts as a firefighter called in when an elderly patient’s medical care has spun out of control.” These doctors “come in, talk to the patient, examine their pills and make recommendations that ideally are aimed at the whole patient, not just his or her heart or lungs or pancreas.” As we pointed out above, this people-centered approach reflects Dr. Taler from Washington, D.C. calls “slow medicine” – and it makes sense to us.

The Politico article (once again, here’s the link) is a long one but it’s well worth the read, whether you’re a senior yourself or you’re seeking wise medical advice for an elderly loved one. We encourage you to contact us at AgingOptions so we can put you in touch with a geriatrician in your area – and we’re confident that a consultation with one of these specialists trained in the care of senior adults will give you a fresh new perspective on how medical care could be.

If you’re ready for a fresh perspective on how retirement could be, then we have another invitation for you: make plans now to join us soon at a free AgingOptions LifePlanning Seminar featuring Rajiv Nagaich. In just a few short hours – with no obligation or pressure of any kind – you’ll learn about our unique and powerful approach to retirement planning, called LifePlanning, in which all the major aspects of retirement are woven together. Your financial plans, legal plans, medical plans and housing plans all need to mesh seamlessly, and it’s also imperative that your family understand and support your wishes as you age. A LifePlan from AgingOptions accomplishes all this and much more.

Our LifePlanningSeminars take place throughout the area, so please click here for details – then register online or call us during the week. “Less is more” may be a good motto when it comes to medical care, but not in the area of retirement planning. Discover the power of a LifePlan soon, at an AgingOptions LifePlanning Seminar near you.

(originally reported at

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