[Smarter Medicine in General Internal Medicine in Hospitals: Where are we now?].

Smarter Medicine in General Internal Medicine in Hospitals: Where are we now? Abstract. In accordance to the "Choosing Wisely" initiative in the United States, Switzerland has launched the "Smarter Medicine" movement in 2014 with the aim to tackle overdiagnosis and overtreatment. A "Smarter Medicine" Top Five List has been developed for Hospital Medicine, pointing out diagnostic tests and treatments with an unfavorable risk-benefit ratio. The five recommendations include: 1) do not order repetitive blood tests or x-rays without specific clinical questions, 2) avoid urinary catheters for the sole purpose of convenience or monitoring urine output in non-critically ill patients, 3) transfuse only the minimum number of red blood cell units necessary, 4) promote the mobilization of hospitalized older patients, and 5) do not prescribe benzodiazepines or other sedative agents to treat insomnia or agitation in older patients. The following article discusses the rationale for the "Smarter Medicine" recommendations for Hospitalists and provides an overview on various interventions implemented in Switzerland and elsewhere aimed at enforcing these recommendations.