Journal
EMERGENCY MEDICINE AUSTRALASIA
Volume 30, Issue 2, Pages 273-278Publisher
WILEY
DOI: 10.1111/1742-6723.12922
Keywords
Bayesian; clinical judgement; low-value care; overdiagnosis; shared decision-making
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It can be difficult to avoid unnecessary investigations and treatments, which are a form of low-value care. Yet every intervention in medicine has potential harms, which may outweigh the potential benefits. Deliberate clinical inertia is the art of doing nothing as a positive response. This paper provides suggestions on how to incorporate deliberate clinical inertia into our daily clinical practice, and gives an overview of current initiatives such as Choosing Wisely' and the Right Care Alliance'. The decision to do nothing' can be complex due to competing factors, and barriers to implementation are highlighted. Several strategies to promote deliberate clinical inertia are outlined, with an emphasis on shared decision-making. Preventing medical harm must become one of the pillars of modern health care and the art of not intervening, that is, deliberate clinical inertia, can be a novel patient-centred quality indicator to promote harm reduction.
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