Choosing Wisely: Next Steps

SOAP‐V: Introducing a method to empower medical students to be change agents in bending the cost curve


Medical students must learn how to practice high‐value, cost‐conscious care. By modifying the traditional SOAP (Subjective‐Objective‐Assessment‐Plan) presentation to include a discussion of value (SOAP‐V), we developed a cognitive forcing function designed to promote discussion of high‐value, cost‐conscious care during patient delivery. The SOAP‐V model prompts the student to consider (1) the evidence that supports a test or treatment, (2) the patient's preferences and values, and (3) the financial cost of a test or treatment compared to alternatives. Students report their findings to their teams during patient care rounds. This tool has been successfully used at 3 medical schools. Preliminary results find that students who have been trained in SOAP‐V feel more empowered to address the economic healthcare crisis, are more comfortable in initiating discussions about value, and are more likely to consider potential costs to the healthcare system. Journal of Hospital Medicine 2016;11:217–220. © 2015 Society of Hospital Medicine

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