Physicians Need to Be Involved in Reducing Costs


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I am so proud of ASCO for participating in the American Board of Internal Medicine Foundation’s Choosing Wisely campaign (see The ASCO Post, May 1, page 19; and page 75 of this issue).

I am the Associate Medical Director for a 280-physician multispecialty group in the Hudson Valley of New York, which was recently granted status as an Accountable Care Organization by the Centers for Medicare & Medicaid Services. I have reached the conclusion that if physicians are not involved in the process of reducing health-care costs, it will not happen in a way that will protect our patients. I am convinced that physicians can reduce costs without impairing care and quality.

It was painful to see that I routinely violate one of ASCO’s Top Five recommendations: I have been dependant on surveillance serologic markers for my patients with breast cancer, even though I know the data are not supportive. I need to rethink that practice and begin explaining the change to my patients.

I feel now is an opportune time to address the issue of liability reform. The Federal government needs to grant liability relief for physicians and specialties that follow practice guidelines outlined in the Choosing Wisely campaign. Only by moving forward together will this effort succeed. The time for political battles and disagreements has past; catastrophic consequences await us all if this effort is not successful.

Thank you for highlighting this issue in The ASCO Post. It has become my favorite newspaper, and I read it regularly from cover to cover. ■

Thomas J. Lester, MD
Associate Medical Director
Mount Kisco Medical Group
Chief, Hematology and Medical Oncology
Northern Westchester Hospital
Mount Kisco, New York


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