In this interview from our recent Institute for Value-Based Medicine® event, Kristine Slam, MD, FACP, Central Ohio Surgical Associates, discusses the positive impact that Choosing Wisely and enhanced recovery after surgery, or EROS, protocols have had on patients receiving treatment for breast cancer.
Kristine Slam, MD, FACP, Central Ohio Surgical Associates, spoke at our recent Institute for Value-Based Medicine® event, held in partnership with the Zangmeister Cancer Center of Columbus, Ohio, on September 14. Here she discusses the positive impact that Choosing Wisely and enhanced recovery after surgery (EROS) protocols have had on patients receiving treatment for breast cancer.
Transcript
What measurable benefits have been observed from the shift to value-based care for breast cancer?
Two of the things that come most to my mind are the Choosing Wisely campaign and EROS protocols.
Choosing Wisely actually started back in 2012, and it was a bunch of societies coming together for mostly patient but also physician education about practices that have been routine for years that actually don't provide that much value to the patient. In the breast cancer world, this actually started by us surgeons not doing unnecessary axillary dissections [or] ordering unnecessary tumor markers. Now it has evolved into, again, ongoing education about not doing routine MRIs, not routinely doing sentinel lymph node biopsies in elderly or low-risk patients, not routinely reexcising lumpectomy close margins. So Choosing Wisely has, again, eliminated both short-term and long-term side effects for patients and financial toxicity.
The second thing that is helpful is something called EROS protocols, and these are specific to surgery. What the EROS protocols are designed for is limiting length of time in the hospital, limiting side effects, and it's through standardization of surgical practices. A lot of this involves preoperative education of patients, but it also is, again, very evidence based about things that work perioperatively to limit patient problems.
Integrated CKD Care Model Cuts ED Visits by 30%, Boosts Specialized Treatment
April 21st 2025An analysis of an interdisciplinary care model for managing chronic kidney disease (CKD) shows hospital admissions dropped by 26% and emergency department (ED) visits decreased by 30% after clinic initiation.
Read More
Personalized Care Key as Tirzepatide Use Expands Rapidly
April 15th 2025Using commercial insurance claims data and the US launch of tirzepatide as their dividing point, John Ostrominski, MD, Harvard Medical School, and his team studied trends in the use of both glucose-lowering and weight-lowering medications, comparing outcomes between adults with and without type 2 diabetes.
Listen
What's at Stake as Oral Arguments Are Presented in the Braidwood Case? Q&A With Richard Hughes IV
April 21st 2025Richard Hughes IV, JD, MPH, spoke about the upcoming oral arguments to be presented to the Supreme Court regarding the Braidwood case, which would determine how preventive services are guaranteed insurance coverage.
Read More
"The Barriers Are Real": Antoine Keller, MD, on Geography and Cardiovascular Health
April 18th 2025Health care disparities are often driven by where patients live, explained Antoine Keller, MD, as he discussed the complex, systematic hurdles that influence the health of rural communities.
Read More