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Faded Promises: The Challenge of Deadopting Low-Value CareThe Challenge of Deadopting Low-Value Care

Benjamin R. Roman, MD; and David A. Asch, MD, MBA
[+] Article and Author Information

This article was published online first at www.annals.org on 29 April 2014.


From the Robert Wood Johnson Foundation Clinical Scholars Program and the Leonard Davis Institute of Health Economics, University of Pennsylvania, Center for Health Equity Research and Promotion, Philadelphia Veterans Affairs Medical Center, Philadelphia, Pennsylvania, and Head and Neck Service, Memorial Sloan Kettering Cancer Center, New York, New York.

Acknowledgment: The authors thank Peter Bach, Jon Baron, Jack Hershey, George Loewenstein, and Victor Fuchs for providing valuable comments about earlier versions of this manuscript.

Financial Support: In part by the Robert Wood Johnson Foundation Clinical Scholars Program.

Disclosures: Disclosures can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M14-0212.

Corresponding Author: David A. Asch, MD, MBA, Blockley Hall 1123, 423 Guardian Drive, Philadelphia, PA 19104; e-mail, asch@wharton.upenn.edu.

Current Author Addresses: Dr. Roman: Blockley Hall 1303, 423 Guardian Drive, Philadelphia, PA 19104.

Dr. Asch: Blockley Hall 1123, 423 Guardian Drive, Philadelphia, PA 19104.

Author Contributions:Conception and design: B.R. Roman, D.A. Asch.

Analysis and interpretation of the data: B.R. Roman, D.A. Asch.

Drafting of the article: B.R. Roman, D.A. Asch.

Critical revision of the article for important intellectual content: B.R. Roman, D.A. Asch.

Final approval of the article: B.R. Roman, D.A. Asch.

Administrative, technical, or logistic support: B.R. Roman, D.A. Asch.

Collection and assembly of data: B.R. Roman, D.A. Asch.


Ann Intern Med. 2014;161(2):149-150. doi:10.7326/M14-0212
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This commentary discusses the difficulty in ceasing practices that physicians have come to believe in despite evidence showing that those practices have little value. The authors suggest several approaches to lessen patient dissatisfaction when attempting to discontinue entrenched low-value practices.

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