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Launching and Leading Change Initiatives in Health Care Organizations: Managing Successful Projects by David A. Shore

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Introduction: The Crowded Runway

Physicians and other clinicians often do too much. They prescribe antibiotics for sinus infections and proton-pump inhibitors for heartburn. They give stress tests to healthy people and cancer tests to dialysis patients. They order X-rays for lower-back pain and brain scans for fainting. These are just a few of the procedures that patients should question, according to a coalition of specialty societies representing some 375,000 U.S. physicians.1 Sometimes the treatment or test is appropriate. Even so, it is often unnecessary as defined in standard medical practice, or overly aggressive, and the procedure becomes part of the estimated 30 percent of health care spending that is wasted.2

Health care organizations ...

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