Episode 12: Getting serious about reducing low-value care: Addressing health system culture and cascades


In this episode, Smarter Care Virginia lead evaluator Dr. John Mafi chats with colleague and fellow low-value care crusader, Dr. Ishani Ganguli on her research around low-value care cascades and reducing low-value care at the health system level. The two discuss the importance of clinician feedback; communication strategies to reduce low-value care; how local health system culture can sink low-value care reduction efforts; and the importance of considering the harmful care cascades that can result from even one low-value health service.

Our Guest: Ishani Ganguli, MD, MPH

Ishani Ganguli MD MPH is an Assistant Professor of Medicine and a primary care physician at Harvard Medical School and Brigham and Women’s Hospital Division of General Internal Medicine and Primary Care. Her research focuses on the value of ambulatory care, the use and consequences of low-value care, and how health care policies and primary care payment and delivery models shape patient and clinician behavior, health outcomes, and spending. Dr. Ganguli serves as an Associate Editor at JAMA Network Open. She is also a journalist who has written about science and health care for The Boston GlobeReutersThe New York Times, and The Washington Post, among other publications. She received her AB, MD, and MPH from Harvard University and completed internal medicine/primary care residency and a health policy and management fellowship at Massachusetts General Hospital.


Low-Value Care at the Actionable Level of Individual Health Systems

Cascades of Care After Incidental Findings in a US National Survey of Physicians