How Do Choosing Wisely Recommendations PDF Improve Healthcare?

My mom ran a clinic her whole life, charging just five dollars for cold medicine. After I took over the clinic, I followed her teachings closely, doing my best to care for the folks in our community. However, after I charged an influencer 30 dollars for medication, I got blasted online as a scam clinic that was out to rob people blind. The entire town showed up at my door, young and old alike, demanding I return the 'overcharged' fees. I gave them exactly what they wanted and refunded every penny before shutting down the clinic for good. "There you go, just like you wanted. The clinic's closed. From now on, if you've got health concerns, feel free to drive 30 miles to the county hospital for consultation. I wish you all good health." The very next day, they were back at my door again. Only this time, they were begging me to reopen.

I was the sole heir to the Thirteen Needles of Revival, a legendary healing art. My consultation fee was twenty thousand dollars per visit, yet every year countless tycoons, politicians, and powerful elites lined up outside my door. As long as a patient still drew breath, the Thirteen Needles of Revival could pull them back from Death's doorstep. Over the past five years, I had awakened a wealthy businessman who had been declared brain-dead after a car accident. I had also prolonged the life of a centenarian suffering from multiple organ failure. Even terminally ill patients whose families had already been told to prepare for the worst were able to walk out of the hospital on their own after receiving my treatment. There was only one ironclad rule. I treated no more than ten patients a year. Once those ten slots were filled, no amount of money, power, or influence could change my mind. Whoever came next would have to wait until the following year. This year, only one slot remained. Suddenly, a group of bodyguards dressed in black burst through the door. They carried in a man covered in blood and dropped to their knees before me. “Please save our boss! We'll pay whatever it takes!” I looked at the man they carried inside and spoke coldly. “Take him out. I wouldn't save this man even if it killed me.”

I was the best surgical hand in the department, and after three flawless operations in a row, I got slapped with an official reprimand and had my entire month's bonus docked. I wasn't having it. I marched straight to the Medical Affairs Office to hash it out with the manager, Gerald Sneed. "I've given this hospital ten years! Name one time I wasn't the first one in when it mattered! Last year, I pulled five surgeries back-to-back and collapsed on my feet by the end of it! What exactly did I do wrong that you're cutting my bonus over?" I was good at what I did, but my life outside the hospital was no easier. Mortgage, car payment, my kid's basketball lessons. I had been counting on that month's bonus to cover it, and now it was gone. I wasn't letting this slide. Since when did a successful surgery count as a mistake? Given my standing at the hospital, Manager Sneed didn't dare go toe-to-toe with me. Instead, he tried to smooth things over. "Dr. Cole, during that surgery you ran at three in the morning two nights ago, you drank two bags of glucose solution off the books, and it ended up billed to the patient. The family found out and accused us of overcharging. It's already blowing up online. Our hands are tied here." That's when it came back to me. That emergency surgery two nights ago had been a mess. It wasn't even supposed to be mine. I had already been on my feet in the OR for thirty-six straight hours, but the deputy director came looking for me and swore no one else could pull it off. So I gritted my teeth and scrubbed in. The surgery went perfectly. And somehow, that was what it got me. I took a breath and changed my tone. "I understand completely. This one's on me. I'll take a month off, go home, and think it over." Manager Sneed, pleased with himself for scoring one against me, approved the leave on the spot. What he didn't expect was that only a week later, the hospital director himself would call, begging me to come back to work.

The new intern in our department, Astrid Stokes, had a soft, harmless look people viewed as innocent. She also claimed she could see a countdown over people's heads, ticking down to their deaths. Most of us just laughed it off and told her she had been reading way too many web novels. When an elderly man was rushed into the ER, she told the department head, Melanie Brooks, not to bother. She said the man wouldn't make it through the day. Melanie ignored her and pushed ahead with everything we had. The old man still died. The attending doctor even got slashed by the patient's family during the fallout. After that, people started to waver. During a team outing, Astrid suddenly screamed and told us not to get on a specific bus. She said if we did, we would all die. With no other choice, we switched vehicles. By the time we reached our destination, news came in. The bus we were supposed to take had lost its brakes and gone off a bridge. After that, almost everyone believed her. Everyone except me. The next day, she pointed straight at me. "Ruth shouldn't be a doctor anymore. If she stays, she'll get caught up in a medical dispute, and the whole department will end up dead or injured." Just like that, Melanie reassigned me. I went from doctor to janitor, handling medical waste. One day, I got scratched by a contaminated needle. Yet, no one would treat me. "Astrid already said it. This is her destiny. Anyone who gets involved will die, too." My body rotted from infection, sores breaking open across my skin. I died alone on the street, full of fury. When I opened my eyes again, I was back to the day Astrid first claimed she could see those death countdowns.

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The mother of Mr. Burr, the hospital director, was critically ill and needed emergency surgery. My wife, wanting to help her beloved crush, Cedric Grey, take the spotlight, deliberately kept the surgery time from me. By the time I finally arrived—late, Mr. Burr stopped me from entering the operating room and scolded me harshly for being unprofessional and unethical. Once I realized what my wife was doing, I handed the lead surgeon position over to her beloved crush. “Well, since you're so eager to shine,” I said coldly, “you’d better not screw it up.” The nurses tried to talk me out of it. They said I was being impulsive, that this was a rare chance to prove myself. However, none of them knew that I was the only doctor in the entire country capable of performing this rare and complex heart valve surgery. Even if Cedric managed to buy time with some miracle drug and made it look like the patient was improving, without my diagnosis and surgical skills, the operation was doomed to fail. And when that happens, he’d be held responsible. As for my wife, her blind favoritism would come back to haunt her.