Minimising waste in the health system

Doctors are important stewards of health care resources and good stewardship is an important part of ethical, best practice care.

The Position Statement explains that stewardship involves avoiding or eliminating wasteful expenditure, with the aim of maximising quality of care and protecting patients from harm, while ensuring affordable care in the future.

Stewardship is not rationing, which involves limiting the amount of health care a person is allowed to have because of economic reasons or scarcity of resources;

AMA President, Dr Michael Gannon, said today that doctors must balance their obligation to minimise wastage of resources with their primary obligation to care for, and protect the health interests of, the individual patient.

“Individual doctors affect health care expenditure through their clinical recommendations and decisions regarding patient treatment,” Dr Gannon said.

“Doctors can reduce wasteful expenditure by applying responsible stewardship to their everyday practices through, for example, appropriate clinical decision-making, minimising diagnostic error, and eliminating tests, treatments or procedures that are unnecessary, inappropriate, or unwanted by the patient.

“This not only reduces waste, but positively influences quality of care.

“Doctors should support patients in making informed health care decisions so that patients receive the care they want, and do not receive tests, treatments, or procedures they do not want.

“Where decisions involving the allocation of health care resources are being made, doctors have a responsibility to advocate for the best interests of patients.

“Doctors must retain their clinical independence and professional autonomy so they can make health care decisions based on the best interests of the patient, and not the interests of third parties.”

Dr Gannon said the Position Statement stresses important messages for the medical profession, including:

• more treatment is not always better treatment;
• expensive treatment is not always better treatment;
• the 'newest' treatment is not always better treatment; and
• be prepared to identify and change established practices that are ineffective or less effective than alternative treatments.

Through undergraduate and post-graduate medical education, as well as continuing professional development, medical students and doctors should learn about actual health care costs and how to practise effective stewardship.

Patients and the wider community should be educated to ensure realistic expectations of certain tests, treatments and procedures, health care costs, and limitations on health care resources;

The AMA Position Statement on the Doctor’s Role in Stewardship of Health Care Resources is available at https://ama.com.au/position-statement/doctors-role-stewardship-health-care-resources-2016

This Position Statement complements the AMA Position Statement on the Role of Doctors in Stewardship of Healthcare Financing and Funding Arrangements 2016 is available athttps://ama.com.au/position-statement/role-doctors-stewardship-health-financing-and-funding-arrangements-2016

21 July 2016

CONTACT:        John Flannery                     02 6270 5477 / 0419 494 761
                      Kirsty Waterford                02 6270 5464 / 0427 209 753

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