Quality Matters: A Podcast by NCQA

Quality Talks With Peggy O'Kane: The Hidden Harms of 'Doing More': A Cardiologist's Perspective


Listen Later

In this episode of Quality Talks With Peggy O’Kane, NCQA President Peggy O'Kane sits down with Dr. Rita Redberg, a cardiology pioneer and fierce advocate for evidence-based care. Dr. Redberg, who famously served as Editor-in-Chief of JAMA Internal Medicine for 14 years, shares her "Less is More" philosophy — a perspective that challenges the view that "more" care is always better.

Join Peggy and Rita as they explore:

  • The Problem with "More": Why a health care culture focused on technology and volume over patient needs leads to runaway costs and poor results.
  • The Stent Story: How a widely adopted procedure in cardiology gained traction without initial evidence of patient benefit, and the uphill battle to integrate rigorous clinical trials.
  • Mary Caldwell's Odyssey: A cautionary tale illustrating the dangerous cascade of unnecessary testing and interventions, based on a desire for reassurance rather than clinical need.
  • Re-evaluating Statins: Rita’s unconventional view on the use of statins in asymptomatic people. She advocates lifestyle changes over medication when the evidence of benefit is thin.
  • Rebuilding Trust: How the fee-for-service payment model erodes the patient-doctor relationship and how regulatory reforms can shift incentives towards patient wellbeing.

Rita reminds us that health care quality isn't about more tests or interventions. It’s about thoughtful, patient-centered decisions and a commitment to "first, do no harm." This episode is a must-listen for anyone curious about improving health outcomes and reducing waste in health care.

Key Quote:

Most statins are prescribed for people that have not already had a heart attack or have established coronary disease. In that higher risk group, there is some benefit to taking statins. It's not huge but there is some benefit.

But most people I see, and most people taking statins, are not in that category. They're healthy people that want to prevent a heart attack and want to live longer. They definitely are not going to feel better. 

Rita Redberg, MD

Time Stamps:

  • (02:09) Misconceptions in Medicine
  • (10:01) Mary Caldwell: A Cautionary Tale
  • (13:35) Choosing Wisely Campaign: A Step Towards Better Care
  • (16:32) Debating the Use of Statins
  • (21:31) Trust, Incentives and the High Cost of US Care
  • (27:05) Technology, Teams and Trust

 

Links:

JAMA Internal Medicine “Less is More”

Choosing Wisely

Connect with Rita

...more
View all episodesView all episodes
Download on the App Store

Quality Matters: A Podcast by NCQABy NCQA

  • 4.6
  • 4.6
  • 4.6
  • 4.6
  • 4.6

4.6

34 ratings


More shows like Quality Matters: A Podcast by NCQA

View all
This American Life by This American Life

This American Life

90,802 Listeners

Planet Money by NPR

Planet Money

30,734 Listeners

Coaching for Leaders by Dave Stachowiak

Coaching for Leaders

1,466 Listeners

Frankly Speaking About Family Medicine by Pri-Med

Frankly Speaking About Family Medicine

255 Listeners

The Daily by The New York Times

The Daily

110,865 Listeners

Up First from NPR by NPR

Up First from NPR

56,021 Listeners

KFF Health News' 'What the Health?' by KFF Health News

KFF Health News' 'What the Health?'

480 Listeners

Ologies with Alie Ward by Alie Ward

Ologies with Alie Ward

23,884 Listeners

Becker’s Healthcare Podcast by Becker's Healthcare

Becker’s Healthcare Podcast

179 Listeners

America Dissected by Incision Media LLC

America Dissected

4,485 Listeners

Tradeoffs by Tradeoffs

Tradeoffs

389 Listeners

How to Be a Better Human by TED

How to Be a Better Human

1,369 Listeners

The Ezra Klein Show by New York Times Opinion

The Ezra Klein Show

15,371 Listeners

The Weekly Show with Jon Stewart by Comedy Central

The Weekly Show with Jon Stewart

10,284 Listeners

HBR On Leadership by Harvard Business Review

HBR On Leadership

156 Listeners