Researcher Anna Adcock (Ngāti Mutunga) is undertaking research on equity components of the Choosing Wisely campaign for the New Zealand Council of Medical Colleges (CMC) and Te Ohu Rata o Aotearoa (Te ORA) – the Māori Medical Practitioners Association. The Health Quality & Safety Commission is a Choosing Wisely partner.
The Choosing Wisely campaign, which is sponsored by CMC, supports reducing unnecessary tests, treatments and procedures in health care. In this blog, Anna Adcock talks about the need to ensure campaigns don’t increase inequities.
The ‘Choosing Wisely means choosing equity’ project explores Māori views on Choosing Wisely and shared decision-making. The goal is to make recommendations on how Choosing Wisely could be implemented in a way that better serves Māori and is more equity focused.
Choosing Wisely originated in America and was introduced in Aotearoa in 2016 – but until recently there hasn’t been an equity focus. The Council of Medical Colleges and Te ORA identified that there was a real need to address this in Aotearoa. Programmes with a ‘one size fits all’ approach don’t work, and can risk increasing inequities.
The Choosing Wisely campaign has the potential to increase inequities, because of its focus on overuse of testing and treatments. Rather than being over tested or treated, Māori are more often under-served by our health system, not receiving adequate or equitable care.
This qualitative project involves talking to Māori whānau (as consumers of health care) and Māori health professionals (from a range of professions) about their views on Choosing Wisely as a campaign, and whether they see value in it for Māori. This includes talking about shared decision-making – what makes a good environment for it, and how Choosing Wisely as a campaign could promote it.
We are covering things like whether the Choosing Wisely resources are appropriate for Māori, if consumers or health professionals see any potential barriers for the campaign, and whether there could be a greater equity focus for Māori.
There appears to have been limited work undertaken internationally looking at equity issues related to the Choosing Wisely campaign. It’s great that the Council of Medical Colleges and Te ORA have facilitated this research, and I hope that other nations will do the same.
Anna Adcock will present her report at the New Zealand Choosing Wisely forum on 1 May 2020 in Wellington.
Author: Anna Adcock