The Dangers of Winter Coats and Car Seats

It has been a very long time since I posted something on my blog. My life has had some changes and I just haven't dedicated any time to  blogging. Will get back to it soon! In the meantime, here is a bit of  safety advice.

Reprinted from Consumer Reports, Emily A. Thomas, Ph.D. / Last updated: October 19, 2018.

How to keep your child warm and safe

Winter brings cold weather and potentially slick roads, but families still need to travel every day. We bundle up our children to help them brave the elements, but a bulky coat and a car seat can be a dangerous combination.

There are ways to safely transport children in child car seats while still keeping them warm. Here are some tips for parents to follow from the experts at CR's Auto Test Center.

Puffy Coat Check

As a general rule, winter coats should not be worn underneath a car seat harness because that can leave the harness too loose to be effective in a crash. Here's a simple way to check whether your child's coat is too big to wear underneath a harness:

Step 1: Put the coat on your child, sit him or her in the car seat and fasten the harness. Tighten the harness until you can no longer pinch any of the webbing with your thumb and forefinger.

Step 2: Without loosening the harness at all, unhook it and remove your child from the car seat. Take the coat off, put your child back in the car seat, and buckle the harness straps, which should be adjusted just as they were when the child was wearing the coat.

If you can pinch the webbing between your thumb and forefinger now, then the coat is too bulky to be worn under the harness.

How to Bundle Up Safely

If you find that the coat can't be safely worn under the harness, here are a couple things you can do:
For smaller children, put a blanket over them to keep them warm.Only use aftermarket covers, essentially fitted blankets, designed to give additional warmth that are approved by the car-seat manufacturer for your specific car seat. Such covers have been tested with the seat and won't compromise your child's safety.

For a bigger child, after securing him or her in the car seat, turn the coat around and put it on backward (with arms through the armholes), so the back of the coat serves as a blanket resting on top of the harness.
One of the most common problems with a child car seat is that the harness is left too loose, and wearing a big winter coat can be just one of the causes.                                                                                           

It's important that the harness is tight enough so that you can't pinch the webbing between your thumb and forefinger. Extra slack in the harness can let the child move to the point where he or she is beyond the protection of the car seat, perhaps even being ejected during a crash.

www.consumerreports.org/car-seats

What You Need to Know About Your New Medicare Card

Replacement cards start coming in April 

and are already triggering new scams

Reprinted from Facebook post: Consumer Reports / Donna Rosato / March 26, 2018

To better protect the 60 million people enrolled in Medicare from identity theft, the government will be sending out new, more secure Medicare cards starting next month.

Instead of identifying members by their Social Security number, the new cards will use a computer-generated series of 11 letters and numbers. The cards will also no longer include a person’s gender or signature.

The use of Social Security numbers on Medicare cards has long been problematic. Whether through theft or fraud, if your number falls into the wrong hands, it can be used to access your bank accounts, steal your Social Security checks, or fraudulently get medical care or prescription drugs in your name.

The change is long overdue, says Casey Schwarz, senior counsel for education and federal policy at the Medicare Rights Center, a nonprofit organization focused on helping older adults and the disabled access affordable healthcare.

“You show your health insurance card to a lot of people you wouldn’t share your Social Security number with,” she says. “The updated cards provide more modern privacy protections and lower the risk of identity theft.” 

Ironically, the change has sparked a wave of scams targeting people using Medicare.

The Federal Trade Commission says the new scams stated almost as soon as the replacement card program was announced.  

In one typical scheme, fraudsters call Medicare beneficiaries on the phone and tell them that in order to get the new card they need to provide Social Security and bank account information, threatening to cancel their Medicare benefits if they don’t provide both.Seniors, who account for 50 million of the 60 million people using Medicare (the other 10 million are disabled), are especially vulnerable to scams, says Brandy Bauer, communications manager for economic security at the National Council on Aging.

Bauer says older adults are targeted more often because they are perceived to have more money. But scams can have an outsized impact on seniors who live on a fixed income and who don’t have time to rebuild savings. 

"You have a lot of unscrupulous people preying on people in Medicare,” she says.

What to Know About Your New Card

You don’t need to do anything to get your card. Medicare won’t call you to ask for personal or financial information, you don’t have to pay get a new card, and your benefits won’t change. Just make sure Medicare has your current mailing address. If it needs to be updated, contact Social Security, which administers the Medicare program. You can update it online by creating an online account, or you can call 800-772-1213. You can also go to a Social Security field office. You can look up your local branch here.

You may not get your card right away. Delivery of the new cards is rolling out over the next year. Go here to see when to expect the card mailings in your area. You can also check out this page Medicare created with details on the new cards.

You can use your current card till 2020. There is a transition period during which you can use either your new Medicare card or your old card at doctors’ offices and hospitals. Both should work until Dec. 31, 2019. After that, shred your old card—don’t just put it in the trash. The new card is smaller, the size of a credit card, so it fits in your wallet more easily. Beginning Jan. 1, 2020, only the new card will be usable.

You should keep your other Medicare cards. About one-third of people get their Medicare benefits through private insurance plans known as Medicare Advantage. Your Medicare Advantage card—which like the new Medicare cards uses a unique identifier, not your Social Security number—will not change and will still be your main card for Medicare. But you may be asked to show your new Medicare card, too, so keep that with you. Same goes if you have a separate plan for prescription drug coverage, Medicare Part D.

You can get help if you are scammed. If you think you are a victim of identity theft or Medicare fraud, contact your state’s Senior Medicare Patrol, a federally funded program to help Medicare beneficiaries, their family, and caregivers. You can also call the Medicare fraud tip line at 800-447-8477 or the Centers for Medicare & Medicaid Services at 800-633-4227. Unlike a Social Security number, which is difficult to change, you can get a different Medicare number if needed.

How Long to Keep Tax Records and Other Documents

You'll also want to safely keep other documents 

for the right amount of time

From FB: Consumer Reports / Last updated: March 08, 2018

Tax season is the perfect time to start culling your paper piles and computer files and getting everything in order. You've already delved into your financial records, so you might as well take the time to organize them. 

There are plenty of good reasons to do this. One is that if you haven't yet completed your taxes, getting your paperwork in order will reduce tax-preparation stress. And if you have already filed your taxes, you'll want to know how long to keep tax records and other financial papers in case you're audited.

There are other instances when being organized can pay off. If you're meeting with a financial adviser or an attorney, you don't want to spend hours wading through clutter to find the documents you need.

If there's a fire, flood, or theft, you'll need access to essential documents quickly. And if you become ill, well-organized paperwork will make it easier for your loved ones to find your healthcare power of attorney, insurance policies, medical records, and outstanding bills.

So what should you do? Divide your financial papers into four categories: papers that you need to keep for the calendar year or less; papers that can be destroyed when you no longer own the items they cover; tax records (we'll tell you how long to keep tax records), and papers to keep indefinitely.

How to Organize Your Records

Keep for less than a year In this file, store your ATM, bank-deposit, and credit card receipts until you reconcile them with your monthly statements. Once you've done that, shred the paper documents (to avoid ID theft) or securely trash electronic files unless you need them to support your tax return. Keep insurance policies and investment statements until new ones arrive. 

Keep for a year or more  You'll want to hold onto loan documents until the loan is paid off. That will often be for more than a year. Then toss those papers. If you own one or more vehicles, hold onto the titles until you sell them. If you have investments in stocks, bonds, mutual funds, or anything else, keep the investment purchase confirmations until you sell the investment so you can establish your cost basis and holding period. (If that information appears on your annual statements, you can keep those instead.)

Keep for seven years  If you fail to report more than 25 percent of your gross income on your tax returns, the government has six years to collect the tax or start legal proceedings. So when it comes to determining how long to keep tax records—electronic and paper—we recommend seven years, just in case.

Keep forever  Essential records such as birth and death certificates, marriage licenses, divorce decrees, Social Security cards, and military discharge papers should be kept indefinitely. Also hold on to defined-benefit plan documents, estate-planning documents, life-insurance policies, and an inventory of your bank safe deposit box (share a copy with your executor or your attorney).

How to Store Your Files

• Use a fireproof safe or password-protected electronic file for the following: Bank and investment statements, estate-planning documents, pension information, insurance policies, pay stubs, tax documents, and your safe deposit box inventory list.                                                                                                                               
• Invest in a safe deposit box for papers that can't be easily replaced: Original birth and death certificates, Social Security cards, passports, life-insurance documents, marriage and divorce decrees, military discharge information, vehicle titles, an inventory of your home's contents (in case you need to make an insurance claim), and loan documents.

How Low Should Your Blood Sugar Go?

Important new guidance for those with type 2 diabetes

From FB: Consumer Reports / Hallie Levine / March 5 2018

People with type 2 diabetes are typically advised to aim for levels of blood sugar, or glucose—the energy from food that fuels our cells and organs—that are close to those for people without diabetes. But just how near-normal these levels should go has long been a matter of disagreement.

Today, after reviewing the current guidelines, the American College of Physicians (ACP) advised that most people with type 2 diabetes not go below 7 percent on the HbA1c test, which measures long-term blood sugar control.

Often, doctors encourage them to strive for an HbA1c of 6.5, which can require high doses of multiple medications. (Normal is less than 5.7, while 5.7 to 6.4 is considered prediabetes—and anything higher is diabetes.) 

But when the ACP analyzed the evidence behind the guidelines, they found that bringing blood sugar levels down to between 7 and 8 was enough to reduce the risks of major diabetes complications such as heart attack, stroke, and damage to eyes, nerves, kidneys, and feet.

“Going lower than that didn’t provide any more benefit, and, in fact, in some cases caused harm by causing blood sugar to drop too low,” explains Jack Ende, M.D., president of the ACP. And left untreated for long enough, low blood sugar, or hypoglycemia, can cause seizures, heart attack, or stroke.

The ACP recommendations are in line with what Consumer Reports and some other organizations have been saying for several years. “It’s much more consistent with what current evidence suggests: Aggressive treatment isn’t just unnecessary for many people but is potentially harmful,” says endocrinologist Marvin M. Lipman, M.D., Consumer Reports’ chief medical adviser.

Not everyone agrees. The American Diabetes Association (ADA), for example, considers an HbA1c of less than 7 percent suitable for the majority of those with type 2 diabetes.

“By lumping ‘most’ people with type 2 diabetes into a 7 percent to 8 percent target range, ACP’s new guidance may cause potential harm to those who may safely benefit from lower evidence-based targets,” says William Cefalu, M.D., chief scientific medical and mission officer at the ADA. 

If you’re currently being treated for type 2 diabetes, here’s what you need to know to make sure that your blood sugar is at the level that’s right for you.

The New Recommendations

To develop its new advice, the ACP reviewed six sets of blood sugar guidelines—from organizations such as the ADA and the American Association of Clinical Endocrinologists—and the evidence behind them. Four of the six recommend a target of 7 percent or lower, and two guidelines suggest a range and advise that doctors take factors such as age and other health issues into consideration.

All the guidelines are based primarily on the findings from five major clinical trials. Some of the trials determined that lowering HbA1c to less than 7 slightly reduced the risk of eye and kidney damage, and others did not.

And, the ACP found, the trials didn’t consistently show that maintaining very low HbA1c numbers helped reduce heart attack, stroke, or deaths overall.

In addition, the evidence suggested that such tight blood sugar control seemed to lead to much higher rates of hypoglycemia—and resulting hospitalizations. 

“Based on our analysis, we felt that the evidence showed that going below 7 percent didn’t reduce deaths or macrovascular complications such as heart attack or stroke, but it did cause harms such as low blood sugar,” Ende says.

In fact, some research found that people who lowered their HbA1c levels to less than 6.5 had a higher risk of death from heart disease than those who were generally between 7 and 8.

The ACCORD study, for example, found that people on intensive drug treatment who got their HbA1c lower than 6 were more than 20 percent more likely to die of any cause, 35 percent more likely to die from heart disease, and almost twice as likely to gain more than 22 pounds.

“When people’s blood sugar gets too low, their body responds as if it’s under major stress: Their heart rate increases and they sweat, both of which increase risk of a cardiac event,” Ende says.

What Should You Do?

The ACP now not only recommends aiming for an HbA1c level of between 7 and 8 percent but also advises that people who dip below 6.5 percent have their diabetes medication doses lowered.

“In these patients it’s reasonable to scale back on dosage and instead encourage them to get their numbers even lower through lifestyle changes such as losing weight and exercising, which carry the same risk-reduction benefits without the potential harm of drugs,” Ende says.

That said, if you have type 2 diabetes, and are younger than 65 and in good health, it’s reasonable to aim for an HbA1c between 6.5 and 7, Lipman says. “And if you’re slightly above the 7 mark—say at 7.1 or 7.2—there’s no reason to push yourself to go any lower. By doing so, you begin to flirt with episodes of low blood sugar,” he says.

If you’re older, and have co-existing health conditions such as heart or lung disease, an HbA1c between 7 and 8 is fine. “In this group, especially if life expectancy is less than a decade, it doesn’t pay to be too strict about it,” Lipman says. That’s because the main purpose of treatment for this group is to prevent symptoms that occur from high blood sugar, such as increased urination, dehydration, and unwanted weight loss, he adds.  

Whether you use diabetes medication or not, it’s important to focus on lifestyle changes—even if your blood sugar is under control.

“Many times, type 2 diabetes can be completely reversed by getting down to a normal weight,” says Michael Hochman, M.D., M.P.H., assistant professor of clinical medicine at the Keck School of Medicine at the University of Southern California and director of the USC Gehr Family Center for Health Systems Science.

One study published in the medical journal The Lancet this past December, for instance, found that about half of people with type 2 diabetes who underwent an intensive weight-management program went into complete remission.

“It’s important for patients to realize that if they are proactive enough about lifestyle, they may not need to be on medication at all,” Hochman says.

Laundry Pod Makers Are Facing More Pressure to Make Packaging Safer

Proposed New York legislation would require product to have a uniform color, 

child-resistant packaging, and warning labels

Reprinted from FB post / Consumer Reports / Kimberly Janeway / Feb  7, 2018

Laundry detergent pod manufacturers are facing renewed pressure to redesign packaging to make their products seem less like colorful candy so that small children or the cognitively impaired won't be enticed to mistakenly eat them and possibly die.   

Two state lawmakers from New York are the latest to call for changes, reintroducing a 2015 bill that would require manufacturers to add warning labels, make the packets a uniform color, and start selling them in child-resistant packaging. 

“The incidence of poisonings hasn’t appreciably decreased since manufacturers undertook voluntary changes,” says Sen. Brad Hoylman, a sponsor of the bill along with a fellow Democrat, Assemblywoman Aravella Simotas.

“This is a serious consumer-health issue. Every year thousands of young children and adults with dementia have been poisoned,” says Hoylman.

Consumer Reports doesn't recommend the use of pods in homes with kids under 6 or anyone with cognitive impairment. We won't recommend pods until we see a meaningful drop in injuries.

“Whether or not the New York bill passes and is signed into law, manufacturers should modify liquid laundry packets to be less attractive to young children and cognitively impaired adults, who mistake the pods for something tasty to eat,” says Don Huber, director of product safety for Consumer Reports. 

Pods are colorful like candy and squishy like playthings. They're designed to dissolve quickly when exposed to water. The concentrated formulation poses a greater health risk than conventional liquid detergent, according to the American Association of Poison Control Centers (AAPCC).

Poisoning Incidents Are Still High

At least eight people have died and many others have been poisoned after ingesting the concentrated liquid laundry detergent packets in recent years. Some lawmakers and consumer-safety advocates also point to a disturbing social media dare called “The Tide Pod Challenge,” in which teenagers have shared video clips of themselves biting into the pods. 

Poison-control centers around the country have received reports of 156 teenagers age 13 to 19 intentionally “exposing” themselves to the pods in January, after the "Tide Pod Challenge" videos began showing up online. The unofficial name of the dare is a parody of Tide advertisements touting the effectiveness of the laundry product.

Though the phenomenon among teenagers has put the safety issue back in the spotlight, the New York bill aims to protect the two most vulnerable populations, young children and adults with cognitive impairments.

In the past five years, poison-control centers have received more than 50,000 calls related to liquid laundry packet detergent exposure, most of them for children under 6 years old.

Simotas and Hoylman are calling for the packaging changes from all manufacturers, including Procter & Gamble, whose Tide Pods and sibling brands account for a majority of liquid laundry packet sales in the U.S. Their bill aims to lower the risk of poisoning by banning the sale of liquid detergent packets in New York State unless the individual packets are opaque instead of clear, and uniform in color.

The bill also calls for each detergent packet to be enclosed in a nonpermeable wrapper with a warning: “Harmful if put in mouth or swallowed. Eye irritant. Keep out of reach of children.” Every container must also have this warning label.

“We support the lawmakers' efforts to improve the safety of detergent packets,” says William Wallace, senior policy analyst for Consumers Union, the advocacy division of Consumer Reports. “Since the packets were first introduced, CR’s product-safety experts and advocates have been pushing the industry to take strong steps to protect consumers. We’re hopeful that there has been progress already, but we also think there’s more that can be done to ensure that these products are safe.”

The American Cleaning Institute, a trade group that includes detergent manufacturers, says the legislation is unnecessary because there are already initiatives addressing the safety of detergent packets.

“Manufacturers have already made major changes to their packaging, including the harder-to-open packaging, the addition of easy-to-understand safety icons, and improving warning labels to advise proper use and storage instructions,” says Brian Sansoni, a spokesman for the group. “Manufacturers of these products are also actively engaged with the Consumer Product Safety Commission to coordinate actions to reduce accidents.”

The bill is now in consumer protection committees in the Senate and the Assembly. If it passes and is signed by Gov. Andrew Cuomo, its mandates will apply to all concentrated liquid detergent packets sold in New York State.

Why It's Important to Get Rid of Unused Medication

The best time to dispose of old meds is Oct. 28: 

National Drug Take Back Day

Consumer Reports /  Ginger Skinner

Last updated: October 26, 2017

When it comes time to dispose of your leftover or expired medicines, you might be tempted to just toss unused pills into the trash—20 percent of people get rid of their meds this way, according to a recent Consumer Reports Best Buy Drugs nationally representative survey of more than 1,000 Americans.

But discarded drugs can contaminate landfill soil and the water supply, according to a study published in 2014 in the journal Environmental Science. And pills can be fished out of the garbage by kids and even pets.

A far better way to dispose of old and unused meds is to drop them off at National Prescription Drug Take Back Day, this Saturday, Oct. 28.

Throughout the U.S., from 10 a.m. to 2 p.m., you can drop off unused pills and liquid medications at designated police departments, fire stations, health clinics, and other facilities in your community for proper disposal. (This doesn’t include inhalers or syringes; see below for how to dispose of those.)

To find a collection site near you, visit TakeBackDay.DEA.gov or call 800-882-9539. Drop-off is free and anonymous.

A Safer Way to Clear Out Old Opioids

To help reduce prescription drug abuse, the Drug Enforcement Administration, in conjunction with the Secure and Responsible Drug Disposal Act of 2010, launched Take Back Day seven years ago. Since then, this twice-yearly event has collected more than 900,000 pounds of medications.

Take Back Day goes a long way toward “eliminating the possibility of a family member or stranger removing your drugs from a medicine cabinet with the intent to misuse or abuse them,” says DEA spokesman Melvin S. Patterson.Many people keep old or unused pills such as opioids in their cabinets because they don’t know how to dispose of them, Patterson says.

Recent research bears that out: According to a survey published last June in JAMA Internal Medicine, 60 percent of people who had been recently prescribed an opioid—Vicodin, Percocet, and others—reported holding on to the drugs for future use. Almost half said that they weren’t aware of how to properly store or dispose of the drugs.Meanwhile, deaths from the use of these drugs have reached epidemic levels—91 people die every day from an opioid overdose, according to the Centers for Disease Control and Prevention.

“Anyone participating in Take Back Day is a welcome part of the solution to a significant problem,” Patterson adds. “It gives everyone an opportunity to take part in ridding our communities of old, unwanted, and potentially harmful drugs.”

The drugs you turn in on Take Back Day are all incinerated—never redispensed or put into landfills, Patterson says.

Other Ways to Dispose

If you can’t participate in Take Back Day this Saturday but still have unused meds to get rid of, follow these steps:

Buy an envelope and mail back your meds. Costco, CVS, and Rite Aid pharmacies sell postage-paid envelopes for a few dollars that allow you to mail any prescription pills or liquids, including opioids and over-the-counter medications, to a disposal facility to be incinerated. (Do not send inhalers or syringes.)

Drop off at a free kiosk in CVS or Walgreens. As part of its initiative to address opioid misuse, CVS this week announced that it plans to offer free, anonymous, secure drug disposal kiosks at 750 pharmacy locations across the U.S. Walgreens already also offers safe drop-off at in-store kiosks. (Medications are incinerated.) To use one, remove your personal information from the bottle or packaging and drop your unwanted or expired medication, including controlled substances, in the slot.

Toss meds in the trash (only if you can’t purchase a mail-back envelope or get to a CVS or Walgreens kiosk). Doing so can contaminate the soil and water supply, so this is not an ideal solution. If you must throw drugs away, first conceal pills (from kids and pets) by mixing them in a bag or another container and mix them with an unappealing substance, like used coffee grounds or kitty litter. Then seal up the container and toss the item into the trash.

Last resort: flushing. This is not ideal because trace amounts of flushed meds can end up in drinking water and possibly harm aquatic life. Our survey found that 17 percent of people said this was their typical disposal method.

The Food and Drug Administration suggests flushing certain drugs, like dangerous opioids, when they are no longer needed, because they could be deadly if accidentally taken by someone else, particularly children.

Disposing of Syringes and Inhalers

You won’t be able to dispose of needles, syringes, or inhalers at National Take Back Day. And it’s not recommended that you throw these items into the trash.

For inhalers, contact your local trash and recycling facility for proper disposal instructions.

For needle disposal, go to safeneedledisposal.org or call 800-643-1643 to find drop-off locations near you. You’ll also find information on pharmaceutical company mail-back programs.

Do Expiration Dates Matter?

Drug manufacturers are required by law to stamp an expiration date on medication bottles, cartons, and tubes; it’s the date the manufacturer can guarantee maximum safety and potency based on testing.

Our medical experts say you can keep most prescription and over-the-counter drugs for about 12 months past the expiration date, with critical exceptions. The antibiotic tetracycline should never be taken after that date, because as tablets break down they can become toxic and cause kidney damage. It’s especially important to keep nitroglycerin and other liquid meds, like insulin and epinephrine (i.e., EpiPens) up-to-date. They lose potency after the expiration date, so they might not work as well or at all in an emergency.

Editor’s Note: This article and related materials are made possible by a grant from the state Attorney General Consumer and Prescriber Education Grant Program, which is funded by the multistate settlement of consumer-fraud claims regarding the marketing of the prescription drug Neurontin (gabapentin).

Why You Need Informed Consent

Here's how to handle this important conversation
about the tests and treatments your doctor recommends

Consumer Reports / By Orly Avitzur, M.D. / August 07, 2017

A fter seeing an ear, nose, and throat doctor for ear pain and congestion, my 21-year-old son was told to come back 2 hours later for “some testing.”

When he returned, no physician was present, and he received no explanation of why the testing (which turned out to be allergy testing) was ordered, how it would be conducted, possible side effects, or available alternatives.

Had that discussion—which is called informed consent—taken place, my son would have simply told them that he’d had allergy testing two weeks earlier.

Informed consent is important to consumers' health for many reasons. Unfortunately, it's also one of the most abused and misunderstood concepts in medical care today. That's why it's important to be truly informed about informed consent.

What Is Informed Consent?

It's intended to be a conversational process when your clinician explains the risks and benefits of a specific test, procedure, surgery, or other treatment.

During this talk, your doctor should also outline other available options and make it clear that you are helping make decisions about your care. You then confirm your understanding of what you’ve been told and agree to—or reject—the doctor's recommendation.

Today, however, some doctors have become far too casual about this process. Instead of a shared discussion, the goal in some cases has shifted to getting you to sign a piece of paper called a release. With your signing, a doctor or hospital feels legally protected in case something goes wrong.

For your consent to be considered valid, it must be voluntary. But most people feel uncomfortable—even intimidated or coerced—when a doctor asks them to sign a release. So they might not speak up, even if they have concerns.

When It Should Happen

Your doctor should initiate an informed consent discussion if he or she recommends anesthesia, surgery, or any invasive procedure (one that “invades” the body, usually by piercing the skin), or if you are asked to be in a clinical research trial.

There is no national consensus on when informed consent is required. It varies from state to state and can be influenced by a doctor or hospital’s interpretation of recommendations from professional and specialty groups.

Those interpretations are not always correct. For example, the American Academy of Allergy, Asthma & Immunology’s sample informed consent form for allergy skin testing notes that a physician or other healthcare professional will be on hand because “occasional reactions may require immediate therapy.” That didn’t happen in my son’s situation.

How the Discussion Should Go

During informed consent, your doctor should explain the procedure, test, or treatment in plain words and without medical jargon—and tell you which roles each healthcare provider plays.

This should be a thorough verbal discussion—a release form should serve as a supplement to this, not a replacement. In fact, the form should merely confirm that the discussion took place.

A good informed consent discussion also uses decision aids, interactive media, or digital tools. It should include information from medical studies, best practices, and clinical guidelines. Your doctor should pull in a qualified medical interpreter, if needed, and allow for assistance for limited English proficiency or hearing or visual impairment.

Making Sure You Understand
During an informed consent talk, you should be able to take notes, bring along a friend or family member, ask questions, get clarifications on anything that’s unclear, and have time to consider your options before you decide. Afterward, it’s useful to summarize back the highlights of what you heard.

If you feel rushed or ignored, ask whether the decision on the proposed test or treatment can be delayed until your doctor can answer your questions fully. (In emergencies, or if you are unable to communicate, informed consent may not be necessary.)

Remember, if you’re uncomfortable, you have the right to say no.

Editor's Note: This article also appeared in the September 2017 issue of Consumer Reports on Health.

Are you willing to be a Choosing Wisely Champion?

http://consumerhealthchoices.org/champion/

Nominate Yourself or Someone Else to Become a

Choosing Wisely Champion!

Consumer Reports is launching a nationwide search to recruit and recognize Choosing Wisely Patient Champions, some of whom we will train to become volunteer activists for the Choosing Wisely campaign. Think you might be one or know one? If so, the details are below, and we’d love to hear from you!

1. Why Choosing Wisely, and what is it?

• Some medical tests and treatments provide little benefit to patients. And in some cases, they even cause harm. Choosing Wisely, a long-running national campaign, promotes conversations between providers and patients with a goal of making sure everyone’s care is as safe, useful, and affordable as possible.

2. Who is a Choosing Wisely Patient Champion?

• Someone who asks their healthcare provider questions to find out if certain medical tests or treatments really are needed – or if there are other options;
• Someone who encourages their friends and family to do the same; and
• Someone who understands that more care is not always better care.

3. Who can be a Patient Champion?

• Almost anyone, including a patient, parent, or caregiver – though you must be at least 18 years old. We are looking for everyday people.
• You cannot be a Patient Champion if you are a healthcare professional (such as a doctor, nurse, or medical student).

4. What does a Patient Champion do?

• Works with Consumer Reports to publicize your story online, in our magazine, via social media, and/or possibly in other ways, such as regional and national conferences; and
• Spreads the message of Choosing Wisely and the importance of talking about overuse with others, and encourages them to share their stories with Consumer Reports; and possibly,
• Considers joining a team of activists by attending and completing the Consumer Reports Consumer Leadership Academy (online and by phone), to learn how to effectively change our culture of medical overuse.

5. What is the nomination process?

• Nominate yourself or someone else by filling out the nomination form. We may contact selected individuals for more information.
• Nominations will be reviewed by a doctor, a patient advocate, and staff from Consumer Reports and the ABIM Foundation to choose 25 champions to be trained as the first group of activists.
• Nominations must be submitted by April 30, 2017.

Please use the form below to nominate yourself or someone else to become a Choosing Wisely Champion. You can also print and complete this form and mail it to us.

More questions? Contact us at HealthImpact@cr.consumer.org.

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Choosing Wisely turns 5!

Happy 5th anniversary to the

#ChoosingWisely campaign

The Choosing Wisely campaign turned 5 on April 4, 2017, and we’re doing all we can to celebrate smart conversations between patients and providers:

1. Seeking Choosing Wisely patient champions.
2. Publishing stories from healthcare providers.
3. Releasing a new video.
4. Tweeting about it.
5. Doing a little dance.

Meet the Consumer Reports' Choosing Wisely team (left to right):  
David Ansley, Yelena Dasher (no longer with us), Dom Lorusso,
Claudia Citarella, Beccah Rothschild

For 5 years Daniel Wolfson (ABIMF) @WolfsonD 
& Tara Montgomery @TaraCivicHealth 
have provided stellar #choosingwisely leadership. 

About the Choosing Wisely campaign

Family doctors know that many patients get unneeded prescriptions. Obstetricians know that too many babies are delivered by C-section. Radiologists have seen a lot of pointless chest X-rays. Blood tests, EKGs, Pap tests and MRIs all are overused.

In fact, when doctors sit down with the medical evidence within their specialties, hundreds of tests and treatments turn out to be frequently unnecessary, duplicative or even harmful.

For the U.S. health system as a whole, it means 30 percent of medical spending is wasted.

For patients? It means their time, energy and money could have been focused on smarter, safer, and more effective care.

The Choosing Wisely campaign aims to help patients and doctors talk about what’s truly needed. The ABIM Foundation has joined with more than 70 medical specialty societies to develop evidence-based lists of tests and procedures that should be questioned.

And as a partner in that effort, Consumer Reports has created more than 120 free brochures for patients and their families, addressing the most common of these concerns. We also have free posters, videos, rack cards, and wallet cards that help people ask their healthcare providers the right questions.

To distribute this material, CR has engaged with more than 50 organizations across the country, who help share it with yet more patients and families.