Georg Röggla: Choosing wisely in Germany

georg_rogglaI attended the annual convention of the German Society of Internal Medicine DGIM (Deutsche Gesellschaft für Innere Medizin) in Mannheim this week. The main focus of this congress is transferring knowledge from bench to bedside and a large proportion of participants are primarily clinicians.

I was interested to see that a BMJ topic was one of the main goals of this year’s convention.

The BMJ started its Too much medicine campaign as early as 2002 with an editorial by Ray Moynihan and Richard Smith. Ten years later the ABIM Foundation (Advancing Medical Professionalism to Improve Health Care) launched Choosing Wisely® with the goal of advancing a national dialogue on avoiding wasteful or unnecessary medical tests, treatments, and procedures.

This has at last reached Germany. The DGIM has formulated five issues that should be avoided and five essentially necessary goals for many subspecialties of internal medicine. These quality targets are intended to avoid medical oversupply and undersupply. In contrast to previous programmes, the German “klug entscheiden” (choose wisely) programme doesn’t only focus on too much medicine but on recommendations with the intention of facilitating wise decisions about the most appropriate care.

These recommendations stimulated a live discussion in the audience. The negative recommendations were unanimously applauded, whereas many physicians considered some of the positive recommendations as slightly banal.

The German choosing wisely recommendations will be shortly published in the journal Deutsches Aerzteblatt.

Georg Röggla is an associate editor with The BMJ.