‘Default Options’ Urged for Medical Care

Some U.S. medical leaders urged initiation of the ‘default option for medical care, allowing an event or condition to occur if no alternative is chosen.

Dr. Scott Halpern of the University of Pennsylvania Health System and colleagues argue such a concept should be used by the medical community to benefit patients.

Halpern and colleagues Drs. Peter Ubel and David Asch said the default option, when properly designed, would improve care for individual patients and promote cost-containment and other social agendas.

For example, the study’s authors said a policy to remove urinary catheters in hospitalized patients after 72 hours, unless physicians or nurses document a reason for maintaining them, could reduce the occurrence of hospital-borne infections.

They also noted the change from opt-in to opt-out policies has increased organ donation rates in many European countries.

The current system allows defaults to be set haphazardly, said Halpern. Instead, physicians and policymakers have a great opportunity to set defaults in ways that help to improve the health of individual patients as well as our entire health-care system.

The commentary appears in the New England Journal of Medicine.