• Emerg Med Australas · Jun 2017

    Critical thinking, curiosity and parsimony in (emergency) medicine: 'Doing nothing' as a quality measure?

    • Gerben Keijzers.
    • Department of Emergency Medicine, Gold Coast University Hospital, Gold Coast, Queensland, Australia.
    • Emerg Med Australas. 2017 Jun 1; 29 (3): 360-362.

    AbstractCurrent medical decision-making is influenced by many factors, such as competing interests, distractions, as well as fear of missing an important diagnosis. This can result in ordering tests or providing treatments that can be harmful. Unnecessary tests are more likely to lead to false positive diagnosis or incidental findings that are of uncertain clinical relevance. Estimates indicate that almost one-third of all health spending is wasteful. The 'Choosing Wisely' campaign has identified many of these wasteful tests and treatments. This perspective proposes some suggestions to focus on our critical thinking, embrace shared decision-making and stay curious about the patient we are treating. Most importantly, 'doing nothing' could be a quality indicator for EDs, and ACEM supported audits and research to develop benchmarks for certain tests and procedures in the ED are important to achieve a cultural change.© 2017 Australasian College for Emergency Medicine and Australasian Society for Emergency Medicine.

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