In a commentary in this week’s Journal of the American Medical Association, Jon Tilburt, M.D., Mayo Clinic Center for the Science of Health Care Delivery, and Christine Cassel, M.D., American Board of Internal Medicine, recommend that doctors practice “parsimonious medicine” — offering patients the most evidence-based therapies in order to control health care costs.
“We need to use resources wisely – delivering appropriate health care that actively avoids wasteful, non-beneficial services,” Dr. Tilburt says. “Experts believe changing medical practice in this way could reduce a big chunk of the 20 – 30 percent of wasteful health care spending.”
Elements of “parsimonious medicine” include starting patients with basic, proven medical care first and calibrating the intensity of testing and treatment according to the patient’s risks and goals.
Unlike health care rationing, parsimonious medicine need not be controversial and is a foundational part of good medical practice everywhere, Dr. Tilburt explains.
“Parsimonious care is not ‘rationing’ because it does not withhold something effective to provide it to others,” write the authors. “To the contrary, it restrains the use of unnecessary and potentially harmful services. Whether the restraint implied in parsimonious medicine could also produce benefits for others lacking basic care is a plausible economic side benefit of doing the right thing.”
Dr. Tilburt explains more: