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Conley Lecturer Gibson Focuses on Stewardship


Rosemary Gibson

If attendees only remember one thing from her John Conley, MD Lecture on Medical Ethics during Sunday’s Opening Ceremony, Rosemary Gibson, senior advisor to The Hastings Center and an editor for JAMA Internal Medicine, hopes it’s the first slide she shared.

Displaying data from the nonpartisan Congressional Budget Office (CBO), the slide showed a line that dramatically curved upward to the right.

“It shows total healthcare spending as a percentage of our total gross domestic product,” Gibson said. “It says if we keep doing what we’re doing, if historical trends in spending persist, by 2082 we’ll be spending 99 percent of our gross domestic product on healthcare.”

Although the CBO created the chart in 2007, Gibson said an updated chart isn’t available. She added that a recent downward trend in healthcare spending is largely due to the recession.

During her lecture, “Stewardship and Why it Matters,” Gibson questioned the necessity of today’s healthcare spending—and what it’s costing the United States in other budget areas. Cities and states across the country are seeing cuts in programs such as education and public safety as healthcare budgets continue to increase.

During the last 10 years in Massachusetts, for instance, there’s been a 59 percent increase in spending on healthcare, Gibson said. Every other line item in the state’s budget has been cut.

“This is the trajectory that we’re on,” she said. “How is it that we can assure the sustainability of the high standards of medical practice for generations to come? The only way I can think about doing that is by taking out the things that don’t add value to the quality of care for patients.

“Invisible tradeoffs are being made every single day.”

Gibson applauded AAO-HNSF’s participation in the Choosing Wisely® campaign, which includes other medical specialty organizations that have identified the top five areas where wasteful spending can be cut based on evidence.

“Take a look at these,” she said. “The overuse of CT scans, unnecessary antibiotics. These are small steps, but imagine if everyone did one thing to be a good steward of healthcare resources and began to change the tide.

“Thank you for thinking of ways to be a good steward of these incredible gifts. Let’s work together to preserve and protect the good that’s in medicine, to maintain the highest standards for generations to come.”