“Low-value care” has been defined as care in which the potential for harm far outweighs possible benefits. When one has the opportunity to consider the phrase in conjunction with its definition, it evokes the notion that patients, their clinicians, and care team are discussing several dimensions of care, weighing the “pros” and “cons,” and arriving at a shared decision. In reality, low-value care is not experienced as a deliberative process. Clinicians often dismiss inquiries about services that may be low value using euphemisms such as “unnecessary,” “inappropriate,” or “wasteful,” without explaining why. This can leave patients wondering whether care is being withheld for more pernicious reasons including bias, rationing, rejection, and racism. This skepticism is particularly prevalent and acute in African American and Latinx communities, whose current and historical experiences have diminished their trust in the health care enterprise.
Without taking the time to deconstruct the many ideas that are trying to be conveyed by the term “low-value care,” the low-value care movement may be defeating the very cause it seeks to champion.