Low value care is a health hazard that calls for patient empowerment

Ian A Scott, Adam G Elshaug and Melissa Fox
Med J Aust 2021; 215 (3): . || doi: 10.5694/mja2.51168
Published online: 19 July 2021

To protect themselves from the potential harms of low value care, patients must take an active role in clinical decision making

Low value care is care that is ineffective, harmful or confers marginal benefit at disproportionately high cost.1 Professionally‐led campaigns such as Choosing Wisely Australia and the Royal Australasian College of Physicians’ EVOLVE program aim to reduce the prevalence of such care. However, similar overseas campaigns have been marred by selective focus on infrequent, low impact, or less financially lucrative practices;2 uncertainty about the most effective de‐adoption strategies;3 and limited success to date in reducing overuse.4 While clinician‐targeted education programs, audit and feedback, and decision support feature prominently, evidence appears stronger and impact seems greater for strategies directed to, or mediated by, patients.5

  • Ian A Scott1,2
  • Adam G Elshaug3
  • Melissa Fox4

  • 1 Princess Alexandra Hospital, Brisbane, QLD
  • 2 University of Queensland, Brisbane, QLD
  • 3 Centre for Health Policy, University of Melbourne, Melbourne, VIC
  • 4 Health Consumers Queensland, Brisbane, QLD


Competing interests:

Adam Elshaug reports personal fees from the Australian Department of Health, the NSW Bureau of Health Information, Cancer Australia, Queensland Health, Victoria Department of Health and Human Services, SA Health, and Private Healthcare Australia; grants from HCF Research Foundation, the National Health and Medical Research Council, the Medical Research Future Fund, the Laura and John Arnold Foundation, and the Australian Department of Veterans Affairs, outside the submitted work. Melissa Fox reports grants and personal fees from Queensland Health, and personal fees from the Australian Commission on Safety and Quality in Health Care, outside the submitted work.


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